Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc
Organization Active NPI Orthopaedic Surgery Physician · Boston, MA
NPI 1972544591 · NPPES record last updated Sep 20, 2018
Key facts
- NPI
- 1972544591
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Orthopaedic Surgery Physician 207X00000X
- Legal business name
- HARVARD MEDICAL FACULTY PHYS AT BETH ISRAEL DEACONESS MED CTR INC
- Practice address
- 330 Brookline Ave
Boston, MA 02215 - Phone
- (617) 663-7441
- Fax
- (617) 667-2155
- NPI assigned
- Jun 8, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Alexandra Boer Kimball, MD
- Title
- Chief Executive Officer
- Phone
- (617) 632-7441
Other NPIs with the same Medicare PAC ID 11
Corporate family (same tax ID) 28
Practitioners 1,763
-
Megan E Anderson, M.D.
-
Paul Timothy Appleton, M.D.
-
Fadi Badlissi, M.D.
-
Stephan C Bruni, NURSE PRACTITIONER
-
Hillary Ann Clarke, PA-C
-
Robert Glen Davis, M.D.
-
Nicole Anne Desrosiers, N.P.
-
Arriyan Dowlatshahi, M.D.
-
Ryan Paige Friedberg, M.D.
-
Brianna Gillen, PA-C, ATC
-
Roman Greer, PA
-
Carl M Harper, M.D.
-
Everett Hayes, M.D.
-
John-Paul David Hezel, M.D.
-
Ishaq O Ibrahim, MD
-
David P. Magit, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040315000691 | MA | Part B Supplier - Clinic/Group Practice | 4486567104 |
Receives reassigned benefits from 83 practitioners Practice locations: Boston, MA; Chestnut Hill, MA; Needham, MA; West Bridgewater, MA |
| O20120802000178 | MA | Part B Supplier - Clinic/Group Practice | 4486567104 |
Receives reassigned benefits from 1 practitioner Practice locations: Newburyport, MA |
National Provider Directory
- Tax ID family
- Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Ce
Locations
330 Brookline Ave
#110
Boston, MA 02215
330 Brookline Ave
#4
Boston, MA 02215
Phone (617) 667-1282
330 Brookline Ave
#309
Boston, MA 02215
Phone (617) 667-3648
330 Brookline Ave
Ste 110
Boston, MA 02215
300 Brookline Ave
#10
Boston, MA 02215
25 Boylston St
Chestnut Hill, MA 02467
Phone (617) 277-2399
313 Speen St
Ste 201
Natick, MA 01760
313 Speen St
Ste 200
Natick, MA 01760
Phone (774) 570-5600
464 Hillside Ave
Ste 304
Needham, MA 02494
Phone (617) 754-0549
47 Obery St
Plymouth, MA 02360
Phone (508) 746-8590
247 Station Dr
Ste NW1
Westwood, MA 02090
Phone (617) 754-1015
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician |
207X00000X | Yes |
Addresses
Primary practice location
330 Brookline Ave
Boston, MA 02215
Mailing address
375 Longwood Ave Ste 3B
Boston, MA 02215-5395
Phone (617) 632-7444
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9782923 | Medicaid | MA |
Other names
- Orthopedic Surgery - HMFP at BIDMC
Other providers in Boston, MA
- Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc
- Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc
- Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc
- Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc
- Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc
- Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc
- Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr, Inc
- Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr, Inc
- Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr, Inc
- Harvard Medical Faculty Physicians
All providers in Boston, MA · Orthopaedic Surgery Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 20, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.