HARVARD MEDICAL FACULTY PHYS AT BETH ISRAEL DEACONESS MED CTR INC (NPI# 1275574899) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275574899 |
| Entity Type | Organization |
| Organization Name | HARVARD MEDICAL FACULTY PHYS AT BETH ISRAEL DEACONESS MED CTR INC |
| Other Organization Name | RADIOLOGY - HMFP AT BIDMC |
| Practice Address |
330 Brookline Ave Boston MA 02215 |
| Mailing Address |
375 Longwood Ave Ste 3 Boston MA 02215-5395 |
| Practice Telephone | 6176327441 |
| Practice Fax Number | 6176672601 |
| Mailing Telephone | 6176327441 |
| Mailing Fax Number | 6176327570 |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2018-06-15 |
| Authorized Official Name | DR. ALEXANDRA BOER KIMBALL (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 6176327441 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085N0700X |
Radiology Specialization: Neuroradiology |
Allopathic & Osteopathic Physicians | ||
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians | ||
| Y | 2085B0100X |
Radiology Specialization: Body Imaging |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 9753397 | 05 |
| Other Name | Type Code |
|---|---|
| Radiology - HMFP at BIDMC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790113389 | Harvard Medical Faculty Phys At Beth Israel Deaconess Med Ctr Inc | Durable Medical Equipment & Medical Supplies | 40 Allied Dr Ste 104, Dedham, MA 02026-6146 | 2013-10-17 |
| 1154435915 | Harvard Medical Faculty Phys At Beth Israel Deaconess Med Ctr Inc | Nurse Practitioner | 330 Brookline Ave # E/tcc-2, Boston, MA 02215 | 2006-08-18 |
| 1538774443 | Harvard Medical Faculty Phys At Beth Israel Deaconess Med Ctr Inc | Clinic/Center | 910 Washington St, Dedham, MA 02026-6022 | 2020-09-09 |
| 1972116754 | Harvard Medical Faculty Phys At Beth Israel Deaconess Med Ctr Inc | Clinic/Center | 910 Washington St, Dedham, MA 02026-6022 | 2020-08-31 |
| 1942334933 | Harvard Medical Faculty Phys At Beth Israel Deaconess Med Ctr Inc | General Acute Care Hospital | 330 Brookline Ave, Boston, MA 02215 | 2007-03-14 |
| 1235218843 | Harvard Medical Faculty Phys At Beth Israel Deaconess Med Ctr Inc | Pediatrics | 330 Brookline Ave, Boston, MA 02215 | 2006-11-03 |
| 1508963901 | Harvard Medical Faculty Phys At Beth Israel Deaconess Med Ctr Inc | General Acute Care Hospital | 330 Brookline Ave, Boston, MA 02215 | 2006-09-20 |
| 1043250616 | Harvard Medical Faculty Phys At Beth Israel Deaconess Med Ctr Inc | Dermatology | 330 Brookline Ave, Masco 3, Boston, MA 02215 | 2006-06-08 |
| 1316987993 | Harvard Medical Faculty Phys At Beth Israel Deaconess Med Ctr Inc | Emergency Medicine | 330 Brookline Ave, Boston, MA 02215 | 2006-06-08 |
| 1346281938 | Harvard Medical Faculty Phys At Beth Israel Deaconess Med Ctr Inc | Pathology | 330 Brookline Ave, Boston, MA 02215 | 2006-06-08 |
| Street Address |
330 BROOKLINE AVE |
| City | BOSTON |
| State | MA |
| Zip Code | 02215 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376541458 | Carolyn Zelop | Obstetrics & Gynecology | 330 Brookline Ave, Ks 306, Boston, MA 02215-5400 | 2005-07-12 |
| 1134735848 | Wassef Chanbour | Ophthalmology | 330 Brookline Ave, Boston, MA 02215-5400 | 2020-09-17 |
| 1174139976 | Christopher Joseph Allen | Nurse Practitioner | 330 Brookline Ave, Boston, MA 02215-5400 | 2020-09-17 |
| 1982218970 | Carleen E Cox | Nurse Practitioner | 330 Brookline Ave, Boston, MA 02215-5400 | 2020-09-07 |
| 1245842319 | Emily Anne Keegan | Nurse Practitioner | 330 Brookline Ave, Boston, MA 02215-5400 | 2020-08-20 |
| 1043822505 | Ann Korkidakis | Student in an Organized Health Care Education/Training Program | 330 Brookline Ave, Kirstein 3, Boston, MA 02215-5400 | 2020-08-17 |
| 1023628468 | Bryar Hasenjaeger | Nurse Practitioner | 330 Brookline Ave, Boston, MA 02215-5400 | 2020-07-31 |
| 1023627262 | Vikram Karnik | Psychiatry & Neurology | 330 Brookline Ave, Boston, MA 02215-5400 | 2020-07-23 |
| 1386252682 | Nancy Littlehale | Nurse Practitioner | 330 Brookline Ave, Boston, MA 02215-5400 | 2020-07-22 |
| 1356968598 | Jessica Catherine Okrant | Nurse Practitioner | 330 Brookline Ave, Boston, MA 02215-5400 | 2020-07-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336746775 | Lee T Gernon-lakin | Physician Assistant | 202 Robinson Hall, 360 Huntington Ave, Boston, MA 02215 | 2020-10-08 |
| 1821695933 | Matthew John Needham | Student in an Organized Health Care Education/Training Program | 330 Brookline Ave, Yamins 2nd Floor, Department of Anesthesia, Boston, MA 02215 | 2020-10-02 |
| 1114533866 | Cdg Back Bay LLC | Clinic/Center | 400 Commonwealth Ave 3rd Floor, Boston, MA 02215 | 2020-09-18 |
| 1619595105 | Natasha Larocque | Radiology | 330 Brookline Avenue, Sherman 231, Beth Israel Deacones, Radiology Education Office, Boston, MA 02215 | 2020-07-10 |
| 1538783089 | Yutsz Cherng | Counselor | 870r Commonwealth Avenue, Boston, MA 02215 | 2020-06-01 |
| 1306495924 | Anthony Rosellini | Psychologist | 900 Commonwealth Avenue (east), 2nd Floor, Boston, MA 02215 | 2019-09-06 |
| 1427605278 | Liana Zucco | Student in an Organized Health Care Education/Training Program | Beth Israel Deaconess Medical Centre, Dept Anesthesia, 330 Brookline Ave, Ya-02q02, Boston, MA 02215 | 2019-08-26 |
| 1831759430 | Brian William Hayes | Radiology | 330 Brookline Avenue, Beth Israel Deaconess Medical Cen, Boston, MA 02215 | 2019-06-17 |
| 1396304358 | Elizabeth Hai Yen Du | Student in an Organized Health Care Education/Training Program | Beth Israel Deaconess Medical Center, Department of Rad, 330 Brookline Avenue, Boston, MA 02215 | 2019-06-12 |
| 1922665439 | Corey Shaphard Miller | Student in an Organized Health Care Education/Training Program | 300 Brookline Avenue, Bidmc, Dana 501, Boston, MA 02215 | 2019-05-21 |
| Find all providers in zip 02215 | ||||
| Taxonomy Code | 2085B0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Body Imaging |
| A Radiology doctor of Osteopathy that specializes in Body Imaging. |
| Notes: Source: National Uniform Claim Committee, 2008 [7/1/2008: definiton added, source added] Additional Resources: The American Osteopathic Board of Radiology no longer offers a certificate in this specialty. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932621471 | Andrew David Chung | Radiology | 330 Brookline Ave Sherman 231, Boston, MA 02215-5400 | 2017-07-15 |
| 1770714651 | Shauna Duigenan | Radiology | Massachusetts General Hospital Abdominal Radiology, 55 Fruit Street White Bldg 270, Boston, MA 02114-3458 | 2009-07-27 |
| 1588631022 | Shyam Dayal | Radiology | 133 Brookline Ave., Dept Radiology, Hvma, Boston, MA 02151-2658 | 2006-03-03 |
| 1134199490 | Matthew David Gilman | Radiology | Massachusetts General Hospital Dept of Radiology, 55 Fruit Street, Fnd 202, Boston, MA 02114 | 2006-01-26 |
| 1801402300 | Xiao Ou He | Radiology | 75 Francis St, Boston, MA 02115-6110 | 2020-09-20 |
| 1316591670 | Alina Makoyeva | Radiology | 330 Brookline Ave # 231, Boston, MA 02215-5400 | 2019-07-25 |
| 1912550724 | Margaret Omolara Adejolu | Radiology | 330 Brookline Ave # 231, Boston, MA 02215-5400 | 2019-07-20 |
| 1962976266 | Nicolas Tabah | Radiology | 330 Brookline Ave, Boston, MA 02215-5400 | 2019-01-20 |
| 1134609068 | Ramy Karam | Radiology | 330 Brookline Ave # 231, Boston, MA 02215-5400 | 2018-08-20 |
| 1154807097 | Kenny Chia Ah-lan | Radiology | 330 Brookline Ave # 231, Boston, MA 02215 | 2018-07-13 |
| Find all providers in BOSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.