Individual provider Active NPI

Scott Gordon Place, MD

  • Student in an Organized Health Care Education/Training Program
  • Boston, MA
National Provider Identifier
1982280632
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
801 Massachusetts Ave
Ste 5a Crosstown BLDG
Boston, MA 02118-3549
Phone
(617) 414-5951
Fax
(617) 414-9251
NPI assigned
Mar 23, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary
Internal Medicine Physician 207R00000X 1018251 MA

Addresses

Primary practice location

801 Massachusetts Ave
Ste 5a Crosstown BLDG
Boston, MA 02118-3549

Mailing address

960 Massachusetts Ave
FL 2
Boston, MA 02118

Other practice location 1

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

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
I20240621000526 MA Practitioner - Internal MedicinePractitioner - Hospitalist 3173912557

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Medical Center Corporation Current Accepting new patients
Evans Medical Foundation, Inc. Internal Medicine CurrentSince Jul 1, 2024 Accepting new patients

Locations

960 Massachusetts Ave
Ste 2
Boston, MA 02118

801 Massachusetts Ave
Ste 5A
Boston, MA 02118

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

725 Albany St
Boston, MA 02118
Phone (617) 414-4075

72 Newton St
Ste 124
Boston, MA 02118
Phone (617) 638-7253

Interoperability endpoints

  • Direct secure messaging: splace140466@direct.bmc.masshiway.net

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1982280632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVE",
            "address_2": "FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MASSACHUSETTS AVE",
            "address_2": "STE 5A CROSSTOWN BLDG",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021183549",
            "telephone_number": "617-414-5951",
            "fax_number": "617-414-9251"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "72 E Newton St Ste 124",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021182308",
            "country_code": "US",
            "telephone_number": "617-638-7253",
            "fax_number": "617-638-6501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PLACE",
        "first_name": "SCOTT",
        "middle_name": "GORDON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-23",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "1018251",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.