NPIMap

Organization Active NPI

Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr, Inc

Doing business as Neurology - HMFP at BIDMC

  • Neurology Physician
  • Boston, MA
National Provider Identifier
1992745236
Registry record updated Sep 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
HARVARD MEDICAL FACULTY PHYS AT BETH ISRAEL DEACONESS MED CTR, INC
Doing business as
Neurology - HMFP at BIDMC
Practice address
330 Brookline Ave
Boston, MA 02215-5400
Phone
(617) 632-7441
Fax
(617) 667-2987
NPI assigned
Jun 7, 2006
Last updated
Sep 20, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2018

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

Authorized official

Name
Alexandra Boer Kimball, MDNPI 1073503603
Title
Ceo and President
Phone
(617) 632-7444

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084N0400X Primary

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 names 1

  • Neurology - HMFP at BIDMC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040315000761 MA Part B Supplier - Clinic/Group Practice 4486567104 Receives reassigned benefits from 86 practitioners
Practice locations: Boston, MA

Other NPIs with the same Medicare PAC ID 11

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Harvard Medical Faculty Physicians29 organizations share this tax ID, including this one

Other organizations with this tax ID 28

Organizations that report the same tax identification number in the National Provider Directory.

View all 28

Locations

185 Pilgrim Rd
#127
Boston, MA 02215

185 Pilgrim Rd
#185
Boston, MA 02215

330 Brookline Ave
#228
Boston, MA 02215
Phone (617) 667-0519

330 Brookline Ave
#406
Boston, MA 02215
Phone (617) 667-0519

330 Brookline Ave
#413
Boston, MA 02215

330 Brookline Ave
#454
Boston, MA 02215

330 Brookline Ave
Rm 810
Boston, MA 02215
Phone (617) 667-4382

330 Brookline Ave
Ste 810
Boston, MA 02215

330 Brookline Ave
Ste KS257
Boston, MA 02215

200 Boylston St
Ste 101
Chestnut Hill, MA 02467
Phone (617) 278-8640

1 University Ave
#213
Westwood, MA 02090

Practitioners & affiliated clinicians

Practitioners 110

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 110

NPI Registry JSON

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

{
    "created_epoch": "1149638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537401600000",
    "number": "1992745236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "375 LONGWOOD AVE STE 3B",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155395",
            "telephone_number": "617-632-7444",
            "fax_number": "617-632-7570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-632-7441",
            "fax_number": "617-667-2987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARVARD MEDICAL FACULTY PHYS AT BETH ISRAEL DEACONESS MED CTR, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-07",
        "last_updated": "2018-09-20",
        "status": "A",
        "authorized_official_last_name": "KIMBALL",
        "authorized_official_first_name": "ALEXANDRA",
        "authorized_official_middle_name": "BOER",
        "authorized_official_title_or_position": "CEO AND PRESIDENT",
        "authorized_official_telephone_number": "617-632-7444",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Neurology - HMFP at BIDMC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Neurology - HMFP at BIDMC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.