ELISE DE (NPI# 1699855619) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699855619 |
| Entity Type | Individual |
| Full Name | ELISE DE |
| Credential | MD |
| Practice Address |
165 Cambridge St Fl 7 Boston MA 02114-2783 |
| Mailing Address |
55 Fruit St # Gb1102 Boston MA 02114-2621 |
| Practice Telephone | 6177260122 |
| Mailing Telephone | (617) 726-3010 |
| Mailing Fax Number | 6177266131 |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2018-03-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | 236214 | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02662164 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| South Clinical Campus, 23 Hackett Blvd. (mc 208), Albany, NY 12208 | 5182623341 |
| Street Address |
165 CAMBRIDGE ST FL 7 |
| City | BOSTON |
| State | MA |
| Zip Code | 02114-2783 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932612124 | Joel Lee | Physician Assistant | 165 Cambridge St Fl 7, Boston, MA 02114-2783 | 2017-11-09 |
| 1629598974 | Elizabeth Shaw | Nurse Practitioner | 165 Cambridge St Fl 7, Boston, MA 02114-2783 | 2017-06-27 |
| 1972844496 | Faith-anne Starr | Physician Assistant | 165 Cambridge St Fl 7, Boston, MA 02114-2783 | 2013-03-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588276281 | Guoliang Qiao | Student in an Organized Health Care Education/Training Program | Massachusetts General Hospital, 55 Fruit Street., Boston, MA 02114 | 2020-08-24 |
| 1881223741 | Alexander Wesley Zirulnik | Student in an Organized Health Care Education/Training Program | 55 Fruit St. Boston, Boston, MA 02114 | 2020-04-03 |
| 1376170548 | Mia Yu Bothwell | Student in an Organized Health Care Education/Training Program | Gray Bigelow 730, 55 Fruit Street, Boston, MA 02114 | 2020-03-26 |
| 1225661036 | David Dongkyung Kim | Student in an Organized Health Care Education/Training Program | 6 Whittier Place, Apartment 15b, Boston, MA 02114 | 2020-02-20 |
| 1124651658 | Madeleine Sertic | Student in an Organized Health Care Education/Training Program | Division of Abdominal Imaging, Department of Radiology, 55 Fruit Street, White 270, Boston, MA 02114 | 2020-02-12 |
| 1285274498 | Jiuk James Jung | Student in an Organized Health Care Education/Training Program | 15 Parkman Ave, Wang 4-460, Boston, MA 02114 | 2020-01-15 |
| 1831740448 | Jennifer Hughes | Physician Assistant | 55 Fruit Street, Founders 110, Boston, MA 02114 | 2019-09-25 |
| 1558827220 | Aluma Chovel Sella | Student in an Organized Health Care Education/Training Program | Massgeneral Hospital for Children Main Campus, 55 Fruit Street, Boston, MA 02114 | 2019-02-18 |
| 1083187140 | Henry Oliveras | Massage Therapist | 102 Charles Street, Boston, MA 02114 | 2019-01-10 |
| 1720550031 | Nicole M Price | Social Worker | 29 Staniford St, Boston, MA 02114 | 2018-12-27 |
| Find all providers in zip 02114 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952796518 | Filipe La Fuente De Carvalho | Urology | 55 Fruit St Dept of Urology, Boston, MA 02114-2621 | 2015-03-31 |
| 1083955538 | Eugene Blanchard Cone | Urology | 55 Fruit St - Grb 1100, Massachusetts General Hospital - Department of Urology, Boston, MA 02114 | 2013-03-08 |
| 1861780983 | Mark Arthur Preston | Urology | 36 Hancock St, Apt 5b, Boston, MA 02114-4117 | 2011-07-11 |
| 1841589132 | Dimitar Zlatev | Urology | 55 Fruit St # 1102, Boston, MA 02114-2621 | 2011-04-07 |
| 1275733867 | Peter Chang | Urology | 330 Brookline Ave # Rabb440, Boston, MA 02215-5400 | 2007-07-20 |
| 1659576189 | Jairam R Eswara | Urology | 45 Francis Street, Asb-iii, Brigham and Women's Hospital, Division of Urology, Boston, MA 02115-6105 | 2007-06-15 |
| 1295769958 | Carlos R Estrada Jr. | Urology | Children's Hospital, Hu390, 300 Longwood Avenue, Dept. of Urology, Boston, MA 02115 | 2006-07-10 |
| 1891733101 | Anurag K Das | Urology | 330 Brookline Ave., Urology, Beth Israel Deaconess Medical Center, Boston, MA 02215 | 2006-06-02 |
| 1699722082 | Andrew A Wagner | Urology | Rabb 440, Beth Israel Deaconess Medical Center, Boston, MA 02215-0000 | 2006-05-30 |
| 1396797619 | Jerome Paul Richie | Urology | 45 Francis Street Asbii 3, Brigham and Womens Hospital Division of Urology, Boston, MA 02115 | 2006-05-16 |
| 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.