BOSTON SPINE GROUP, LLC. (NPI# 1558316166) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558316166 |
| Entity Type | Organization |
| Organization Name | BOSTON SPINE GROUP, LLC. |
| Practice Address |
299 Washington Street Newton MA 02458-1612 |
| Mailing Address |
P.o. Box 4110 Department 3110 Woburn MA 01888-4110 |
| Practice Telephone | 6172196300 |
| Practice Fax Number | 6172196355 |
| Mailing Telephone | 7816190173 |
| Mailing Fax Number | 7815515888 |
| Enumeration Date | 2006-05-23 |
| Last Update Date | 2015-03-09 |
| Authorized Official Name | ROBERT JUDE RANCO (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6172196300 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207XS0117X |
Orthopaedic Surgery Specialization: Orthopaedic Surgery of the Spine |
59668 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | BCBS MA | M19170 | 01 |
| Street Address |
299 WASHINGTON STREET |
| City | NEWTON |
| State | MA |
| Zip Code | 02458-1612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225083579 | Boston Spine Teaching and Research Foundation Inc. | Orthopaedic Surgery | 299 Washington Street, Newton, MA 02458-1612 | 2006-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699372136 | Marie Beh Buckhout | Chiropractor | 517 Washington Street, Newton, MA 02458 | 2020-10-07 |
| 1619583168 | Newton Wellesley Dental Group LLC | Clinic/Center | 447 Centre Street, Same, Newton, MA 02458 | 2020-09-21 |
| 1083179220 | Leslie Gary Brody | Social Worker | 35 Buswell Park, Newton, MA 02458 | 2019-02-01 |
| 1114499043 | Anne Irene Vermeulen | Health Educator | 55 Chapel Street, Suite 300, Newton, MA 02458 | 2018-12-17 |
| 1669957023 | Marla Rutenberg | Social Worker | 4 Cotton Street, Newton, MA 02458 | 2018-10-01 |
| 1104339787 | Stephanie Chancey | Counselor | 425 Watertown Street, The Academy, Newton, MA 02458 | 2017-11-06 |
| 1356886485 | Elizabeth Woodruff | Social Worker | 77 Warren St. Building #9, Brighton, MA 02458 | 2016-12-28 |
| 1346618519 | Jessica Farnsworth Kruss | Counselor | 425 Rear Watertown St., Newton, MA 02458 | 2015-09-04 |
| 1043631591 | Judith Sheolie Fernando | Psychiatry & Neurology | 313 Washington Street Newton, Newton, MA 02458 | 2014-01-01 |
| 1861830887 | Allison L. Phillips | Social Worker | 64 Eldredge St., Newton, MA 02458 | 2013-06-12 |
| Find all providers in zip 02458 | ||||
| Taxonomy Code | 207XS0117X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| Specialization | Orthopaedic Surgery of the Spine |
| Recognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic surgeons of the spine deal with the evaluation and nonoperative and operative treatment of the full spectrum of primary spinal disorders including trauma, degenerative, deformity, tumor, and reconstructive. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Separate board certification is not currently offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285636993 | Louis G Jenis | Orthopaedic Surgery | 299 Washington St, Newton, MA 02458-1612 | 2005-08-12 |
| 1225083579 | Boston Spine Teaching and Research Foundation Inc. | Orthopaedic Surgery | 299 Washington Street, Newton, MA 02458-1612 | 2006-05-24 |
| 1689636037 | Mitchell Alan Hardenbrook | Orthopaedic Surgery | 2014 Washington St, Newton, MA 02462-1607 | 2006-04-03 |
| 1265434948 | Robert J Banco | Orthopaedic Surgery | 299 Washington St, Newton, MA 02458-1612 | 2005-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225518848 | Leah Witkin | Orthopaedic Surgery | 55 Fruit St Ste 3800, Boston, MA 02114-2621 | 2018-08-14 |
| 1104195981 | Kshitij Chaudhary | Orthopaedic Surgery | 44 Washigton Street #217, Brookline, MA 02445 | 2011-12-22 |
| 1376657056 | James Cushing Bayley | Orthopaedic Surgery | 736 Cambridge St # Ccp-9, Bone and Joint Center, Boston, MA 02135-2907 | 2006-08-18 |
| 1841292414 | Frank X Pedlow Jr. | Orthopaedic Surgery | 30 Lancaster St, 2nd Floor, Boston, MA 02114-1704 | 2005-08-12 |
| 1619507043 | Boston Orthopaedic & Spine LLC | Orthopaedic Surgery | 20 Guest St Ste 225, Brighton, MA 02135-2065 | 2020-01-24 |
| 1679132070 | Boston Orthopedic Spine Care Inc | Orthopaedic Surgery | 822 Boylston St, Chestnut Hill, MA 02467-2595 | 2019-06-10 |
| 1962889295 | Robert J. Banco, Md, PC | Orthopaedic Surgery | 25 Washington St, Unit # 1-b, Wellesley, MA 02481-1752 | 2015-05-06 |
| 1619399961 | Paul Glazer, Md, LLC | Orthopaedic Surgery | 330 Brookline Ave, Boston, MA 02215-5400 | 2014-01-06 |
| 1275978538 | Matthew Joseph Sabatino | Orthopaedic Surgery | 150 S Huntington Ave, Boston, MA 02130-4817 | 2013-05-01 |
| 1417207762 | Harvey E Smith Md LLC | Orthopaedic Surgery | 125 Parker Hill Ave, Conv 4, Boston, MA 02120-2847 | 2012-09-13 |
| Find all providers with the same taxonomy | ||||
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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.