Individual provider Active NPI

Alexander Nagrebetsky, M.D. M.SC.

  • Student in an Organized Health Care Education/Training Program
  • Chicago, IL
National Provider Identifier
1942642012
Registry record updated Jul 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
1933 W Polk St
Room SSR 1311B
Chicago, IL 60612-4891
Phone
(312) 662-2708
NPI assigned
Jul 18, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 125063675 IL
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

1933 W Polk St
Room SSR 1311B
Chicago, IL 60612-4891

Mailing address

1933 W Polk St
Room SSR 1311B
Chicago, IL 60612-4891
Phone (312) 662-2708

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180516000854 MA Practitioner - Anesthesiology 5597061572 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Massachusetts General Physicians Organization IncGroup PAC ID 2466365820, 3,494 clinicians

Practice addresses (Care Compare)

55 Fruit St
Boston, MA 02114-2696
Phone (617) 724-0287

Hospital & facility affiliations

  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
  • Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Jul 1, 2018 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Jul 1, 2018 Accepting new patients
General Hospital Corp Current Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

Interoperability endpoints

  • Direct secure messaging: nagrebetsky.alexander.mgh@direct.partners.masshiway.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1374105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374105600000",
    "number": "1942642012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1933 W POLK ST",
            "address_2": "ROOM SSR 1311B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124891",
            "telephone_number": "312-662-2708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1933 W POLK ST",
            "address_2": "ROOM SSR 1311B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606124891",
            "telephone_number": "312-662-2708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAGREBETSKY",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "M.D. M.SC.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-18",
        "last_updated": "2013-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "125063675",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.