Individual provider Active NPI

Sushma Boppana, M.D.

  • Anatomic Pathology & Clinical Pathology Physician
  • Brookline, MA
National Provider Identifier
1992797690
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
236771 Issued in MA
Practice address
13 Griggs Ter
Brookline, MA 02446-4702
Phone
(631) 327-4841
NPI assigned
Aug 18, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 199972 NY
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 236771 MA Primary

Addresses

Primary practice location

13 Griggs Ter
Brookline, MA 02446-4702

Mailing address

13 Griggs Ter
Brookline, MA 02446-4702
Phone (631) 327-4841

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
I20080717000101 MA Practitioner - Pathology 5294808739 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mass General Brigham Community Physicians IncGroup PAC ID 1759273436, 430 clinicians
Brigham and Womens Physicians Organization IncGroup PAC ID 3870405988, 2,931 clinicians

Practice addresses (Care Compare)

170 Governors Ave
Medford, MA 02155-1643
Phone (781) 395-4909

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

81 Highland Ave
Salem, MA 01970-2714
Phone (978) 354-4181

Hospital & facility affiliations

  • North Shore Medical Center - Hospital, Salem, MA, CCN 220035
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
  • Newton-Wellesley Hospital Hospital, Newton, MA, CCN 220101

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
199972NYMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Pathology Partners, P.C. Anatomic Pathology & Clinical Pathology CurrentSince Apr 4, 2022 Accepting new patients
Brigham & Womens Physicians Organization Inc Anatomic Pathology & Clinical Pathology CurrentSince Nov 15, 2022 Accepting new patients
Mass General Brigham Community Physicians Inc CurrentSince Apr 1, 2025 Accepting new patients
General Hospital Corp Current Accepting new patients
New York University Medical Center Pathology Associates Anatomic Pathology & Clinical Pathology PastSince Aug 1, 1991 Accepting new patients

Locations

75 Francis St
Boston, MA 02115

1153 Centre St
Jamaica Plain, MA 02130
Phone (617) 983-7000

170 Governors Ave
Medford, MA 02155
Phone (781) 306-6000

2014 Washington St
Newtonville, MA 02462
Phone (617) 243-6000

81 Highland Ave
Salem, MA 01970
Phone (978) 354-4009

Interoperability endpoints

  • Direct secure messaging: boppana.sushma.mgh@direct.partners.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 3

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": "1124323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729555200000",
    "number": "1992797690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 GRIGGS TER",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024464702",
            "telephone_number": "631-327-4841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 GRIGGS TER",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024464702",
            "telephone_number": "631-327-4841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOPPANA",
        "first_name": "SUSHMA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-18",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "NY",
            "license": "199972",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "MA",
            "license": "236771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

Verify at the official NPI Registry.