NPIMap

Individual provider Active NPI

Ivan Luptak Jr., M.D.

  • Cardiovascular Disease Physician
  • Boston, MA
National Provider Identifier
1962650853
Registry record updated Dec 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
237871 Issued in MA
Practice address
732 Harrison Ave
Preston 3Rd Floor
Boston, MA 02118-2309
Phone
(617) 638-7490
NPI assigned
Sep 4, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 237871 MA
Cardiovascular Disease Physician 207RC0000X 237871 MA Primary

Addresses

Primary practice location

732 Harrison Ave
Preston 3Rd Floor
Boston, MA 02118-2309

Mailing address

801 Albany Street
FL Ground
Boston, MA 02119
Phone (617) 414-5405

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081224000175 MA Practitioner - Advanced Heart Failure and Transplant CardiologyPractitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 2466514534 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Advanced Heart Failure and Transplant CardiologyAlso: Cardiovascular Disease (Cardiology), Internal Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Evans Medical Foundation IncGroup PAC ID 7416946546, 525 clinicians

Practice addresses (Care Compare)

1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (617) 638-8000

72 E Newton St
CR Evans 124
Boston, MA 02118-2308
Phone (617) 638-7253

88 E Newton St
Boston, MA 02118-2308
Phone (617) 414-5405

Hospital & facility affiliations

  • Boston Medical Center Hospital, Boston, MA, CCN 220031
  • Sturdy Memorial Hospital Hospital, Attleboro, MA, CCN 220008

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
237871MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Evans Medical Foundation, Inc. Internal Medicine CurrentSince Oct 1, 2013 Accepting new patients
South Shore Cardiology PC Cardiovascular Disease CurrentSince Oct 1, 2015 Accepting new patients
Boston Medical Center Corporation Current Accepting new patients
Steward Medical Group, Inc CurrentSince Dec 10, 2014 Accepting new patients
Steward Medical Group, Inc CurrentSince Dec 10, 2014 Accepting new patients

Locations

88 Newton St
Boston, MA 02118
Phone (617) 638-7350

732 Harrison Ave
Fl 3
Boston, MA 02118
Phone (617) 638-5350

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

800 Washington St
Norwood, MA 02062
Phone (781) 278-6264

825 Washington St
Ste 340
Norwood, MA 02062
Phone (781) 762-6581

720 Harrison Ave
#503
Roxbury, MA 02118
Phone 6174145404 ext. 2

70 Pleasant St
Weymouth, MA 02190
Phone (781) 331-2000

Interoperability endpoints

  • Direct secure messaging: iluptak11114@direct.bmc.masshiway.net

Organizations & group practices 5

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 9

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": "1220486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577404800000",
    "number": "1962650853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 ALBANY STREET",
            "address_2": "FL GROUND",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02119",
            "telephone_number": "617-414-5405",
            "fax_number": "617-414-6031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "732 HARRISON AVE",
            "address_2": "PRESTON 3RD FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182309",
            "telephone_number": "617-638-7490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUPTAK",
        "first_name": "IVAN",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-09-04",
        "last_updated": "2019-12-27",
        "certification_date": "2019-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "237871",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": "237871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.