Keith Jay Dreyer, DO PHD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

79753 Issued in MA

Practice address

55 Fruit St
E00 3E Radiological Associates
Boston, MA 02114-2696

Phone

(617) 724-1962

Fax

(617) 724-5597

NPI assigned

Nov 3, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343260800000",
    "number": "1962493478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9142",
            "address_2": "MASS GENERAL PHYSICIAN ORGANIZATION",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021299142",
            "telephone_number": "617-724-0287",
            "fax_number": "617-726-2894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "E00 3E RADIOLOGICAL ASSOCIATES",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142696",
            "telephone_number": "617-724-1962",
            "fax_number": "617-724-5597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DREYER",
        "first_name": "KEITH",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "DO PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2012-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "79753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "J30723",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "750053",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3128504",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natalie Grace Utley Drew, MD
• Stephen J Drewniak, MD
• Reed E. Drews, MD
• Anna Dreyer, PT, DPT
• Elizabeth J. Dreyer
• Emma Bess Dreyfus, LICSW
• Jeffrey Bradford Driban, PHD, ATC, CSCS
• Mark E. Drinkwater, NP
• Brittni Pritpal Driscoll
• Devin Marie Driscoll, MD

• Diagnostic Radiology Physician in Boston, MA
• Providers in Boston, MA by specialty
• Diagnostic Radiology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.