DR. SPENCER DEGERSTEDT (NPI# 1841649019) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841649019 |
| Entity Type | Individual |
| Full Name | DR. SPENCER DEGERSTEDT |
| Credential | MD |
| Practice Address |
330 Brookline Ave Boston MA 02215-5400 |
| Mailing Address |
3411 Sw Us Veterans Hospital Rd Apt 4 Portland OR 97239-2986 |
| Practice Telephone | 6176677000 |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2019-05-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0204X |
Radiology Specialization: Vascular & Interventional Radiology |
1841649019 | OR | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3411 Sw Us Veterans Hospital Rd Apt 4, Portland, OR 972392986 | 5038816563 |
| Street Address |
330 BROOKLINE AVE |
| City | BOSTON |
| State | MA |
| Zip Code | 02215-5400 |
| 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 | 2085R0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Vascular & Interventional Radiology |
| A radiologist who diagnoses and treats diseases by various radiologic imaging modalities. These include fluoroscopy, digital radiography, computed tomography, sonography and magnetic resonance imaging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528407467 | Amar C Gupta | Radiology | 55 Fruit St # 290, Boston, MA 02114-2621 | 2013-06-24 |
| 1942761127 | Olumide Ayodeji Olulade | Radiology | 75 Francis St, Boston, MA 02115-6106 | 2019-03-28 |
| 1265997480 | Emalyn Phillips Johnson | Radiology | 300 Longwood Ave, Boston, MA 02115-5724 | 2019-02-01 |
| 1851704514 | William Robert Johnson | Radiology | 75 Francis St, Boston, MA 02115-6110 | 2014-06-10 |
| 1417360140 | Mohammad Bader | Radiology | 840 Harrison Ave, Boston, MA 02118-2905 | 2014-06-10 |
| 1730509621 | David Guez | Radiology | 840 Harrison Ave, Boston, MA 02118-2905 | 2014-04-18 |
| 1346687894 | Ezra Burch | Radiology | 75 Francis St, Boston, MA 02115-6110 | 2013-05-23 |
| 1427314970 | Yan Epelboym | Radiology | 840 Harrison Ave, Boston, MA 02118 | 2012-04-10 |
| 1750660239 | Ian Brennan | Radiology | 330 Brookline Ave, Boston, MA 02215-5400 | 2011-08-15 |
| 1225352552 | Pradeep Govender | Radiology | 75 Francis Street, Brigham & Women's Hospital, Boston, MA 02115 | 2010-03-15 |
| 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.