Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr, Inc
Organization Active NPI Neurology Physician · Boston, MA
NPI 1992745236 · NPPES record last updated Sep 20, 2018
Key facts
- NPI
- 1992745236
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Neurology Physician 2084N0400X
- Legal business name
- HARVARD MEDICAL FACULTY PHYS AT BETH ISRAEL DEACONESS MED CTR, INC
- Practice address
- 330 Brookline Ave
Boston, MA 02215-5400 - Phone
- (617) 632-7441
- Fax
- (617) 667-2987
- NPI assigned
- Jun 7, 2006
- Organization subpart
- No
Authorized official
- Name
- Alexandra Boer Kimball, MD
- Title
- Ceo and President
- Phone
- (617) 632-7444
Other NPIs with the same Medicare PAC ID 11
Corporate family (same tax ID) 28
Member organizations 2
Practitioners 1,735
-
Rikka Azuma, MD
-
Edward Wadie Bahou, M.D.
-
Niravkumar Barot, MD
-
Aimee Kirsten Boegle, M.D.
-
Stephanie Samantha Buss, M.D.
-
Bernard S Chang, M.D.
-
Stephanie Changeau, MSN,FNP BC
-
Hsueh-Sheng Chiang, M.D., PH.D.
-
Sandy Chikel, NP
-
Corey R Fehnel, M.D.
-
Marc Fisher, MD
-
Tamara G. Fong, M.D., PH.D.
-
Samuel Arthur Frank, M.D.
-
Roy L Freeman, M.D.
-
Garrett Friedman, MD
-
Christopher H Gibbons, M.D.
-
Daniel M Goldenholz, MD, PHD
-
Laurie Gordon, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040315000761 | MA | Part B Supplier - Clinic/Group Practice | 4486567104 |
Receives reassigned benefits from 86 practitioners Practice locations: Boston, MA |
National Provider Directory
- Tax ID family
- Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Ce
Locations
330 Brookline Ave
#454
Boston, MA 02215
185 Pilgrim Rd
#185
Boston, MA 02215
330 Brookline Ave
Ste KS257
Boston, MA 02215
171 Pilgrim Rd
#2W
Boston, MA 02215
330 Brookline Ave
#406
Boston, MA 02215
Phone (617) 667-0519
330 Brookline Ave
Ste 810
Boston, MA 02215
330 Brookline Ave
#228
Boston, MA 02215
Phone (617) 667-0519
330 Brookline Ave
#413
Boston, MA 02215
330 Brookline Ave
Rm 810
Boston, MA 02215
Phone (617) 667-4382
185 Pilgrim Rd
#127
Boston, MA 02215
1 University Ave
#213
Westwood, MA 02090
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician |
2084N0400X | Yes |
Addresses
Primary practice location
330 Brookline Ave
Boston, MA 02215-5400
Mailing address
375 Longwood Ave Ste 3B
Boston, MA 02215-5395
Phone (617) 632-7444
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9782931 | Medicaid | MA |
Other names
- Neurology - 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 Physicians
- Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Ce
- Harvard School of Dental Medicine
- Harvard School of Dental Medicine
- Harvard School of Dental Medicine
All providers in Boston, MA · Neurology 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.