Active NPI
Alex Gervacio Cuenca, MD
- Pediatric Surgery Physician
- Boston, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Surgery Physician
- License
- 270597
- Practice address
- 300 Longwood Ave
Boston, MA 02115-5724 - Phone
- (617) 355-6000
- NPI assigned
- Nov 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 511220 | FL | |
| Surgery Physician | 208600000X | 270597 | MA | |
| Pediatric Surgery Physician | 2086S0120X | 270597 | MA | Primary |
Addresses
Primary practice location
300 Longwood Ave
Boston, MA 02115-5724
Mailing address
300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-6000
Other practice location 1
725 Albany St, Suite 3B
Shapiro Bldg.
Boston, MA 02118-3549
Phone (617) 414-5131
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110153783A | Medicaid | MA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- General Surgery
- Education
- University of Florida College of Medicine, 2006
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-6000
Hospital & facility affiliations
- Boston Children'S Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 511220 | FL | MD | Surgery Physician |
| 270597 | MA | MD | Pediatric Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boston University General Surgical Associates, Inc.-QMC | Current | Accepting new patients | |
| Boston University General Surgical Associates, Inc. | Surgery | Current | Accepting new patients |
| CHMC Surgical Foundation Inc | Current | Accepting new patients | |
| Children'S Hospital Corporation | Past | Accepting new patients |
Locations
300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956
732 Harrison Ave
Fl 5
Boston, MA 02118
Phone (617) 414-6840
725 Albany St
Ste 3B
Boston, MA 02118
Phone (617) 638-8485
Interoperability endpoints
- acuenca27601@direct.bostonchildrens.org
Organizations & group practices 4
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.
-
- Pediatric Surgery Physician
- Boston, MA
- NPI 1902977515
-
- Surgery Physician
- Boston, MA
- NPI 1104865567
-
- Podiatrist
- Quincy, MA
- NPI 1396041356
-
- Children's Hospital
- Boston, MA
- NPI 1710087127
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Children's Hospital
- Boston, MA
- NPI 1710087127
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164585600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736899200000",
"number": "1992871412",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 LONGWOOD AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021155724",
"telephone_number": "617-355-6000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 LONGWOOD AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021155724",
"telephone_number": "617-355-6000"
}
],
"practiceLocations": [
{
"address_1": "725 Albany St, Suite 3B",
"address_2": "Shapiro Bldg.",
"address_purpose": "LOCATION",
"city": "Boston",
"state": "MA",
"postal_code": "021183549",
"country_code": "US",
"telephone_number": "617-414-5131",
"fax_number": "617-414-5131",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CUENCA",
"first_name": "ALEX",
"middle_name": "GERVACIO",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-11-27",
"last_updated": "2025-01-15",
"certification_date": "2025-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "FL",
"license": "511220",
"primary": false
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MA",
"license": "270597",
"primary": false
},
{
"code": "2086S0120X",
"taxonomy_group": "",
"desc": "Surgery, Pediatric Surgery",
"state": "MA",
"license": "270597",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110153783A",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
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 Jan 15, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.