IVAN LUPTAK JR. (NPI# 1962650853) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962650853 |
| Entity Type | Individual |
| Full Name | IVAN LUPTAK JR. |
| Credential | M.D. |
| Practice Address |
732 Harrison Ave Preston 3rd Floor Boston MA 02118-2309 |
| Mailing Address |
801 Albany Street Fl Ground Boston MA 02119 |
| Practice Telephone | 6176387490 |
| Mailing Telephone | 6174145405 |
| Mailing Fax Number | 6174146031 |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2019-12-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 237871 | MA | Allopathic & Osteopathic Physicians |
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
237871 | MA | Allopathic & Osteopathic Physicians |
| Street Address |
732 HARRISON AVE PRESTON 3RD FLOOR |
| City | BOSTON |
| State | MA |
| Zip Code | 02118-2309 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336146810 | Hans K Meier-ewert | Internal Medicine | 732 Harrison Ave, Preston Building - 3rd Floor, Boston, MA 02118-2309 | 2005-06-30 |
| 1972144236 | Christina Ann Guerriero | Physician Assistant | 732 Harrison Ave, Preston 2nd Fl, Boston, MA 02118 | 2019-10-07 |
| 1861045478 | Kristen Fein | Nurse Practitioner | 732 Harrison Ave, 3rd Floor, Boston, MA 02118 | 2019-07-23 |
| 1730732314 | Oluwakemi Olotu | Family Medicine | 732 Harrison Ave, Fl 3, Boston, MA 02118 | 2019-07-22 |
| 1174082143 | Ashley Dinah Daniel | Student in an Organized Health Care Education/Training Program | 732 Harrison Ave, Boston, MA 02118-2309 | 2019-03-18 |
| 1023522497 | Tram T Tran | Nurse Practitioner | 732 Harrison Ave, Preston, 2nd Floor, Boston, MA 02118 | 2017-11-21 |
| 1083127658 | Lorely Torres | Nurse Practitioner | 732 Harrison Ave, Preston, 2nd Floor, Boston, MA 02118 | 2017-11-06 |
| 1093246951 | Heidi Michelle Fuller | Student in an Organized Health Care Education/Training Program | 732 Harrison Ave, Podiatry Clinic 5th Floor, Boston, MA 02118-2309 | 2017-03-22 |
| 1407306731 | Colin Flynn | Physician Assistant | 732 Harrison Ave, Preston, 3rd Floor, Boston, MA 02118-2309 | 2016-10-11 |
| 1639627649 | Jessica Nicole Fernandes | Physician Assistant | 732 Harrison Ave, Preston, 3rd Floor, Boston, MA 02118-2309 | 2016-09-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649870023 | Carlos E Salazar | Counselor | Hcrc 23 Bradston St., Boston, MA 02118 | 2020-10-27 |
| 1780292607 | Jinal Gandhi | Student in an Organized Health Care Education/Training Program | Shapiro Primary Care, 725 Albany Street, Boston, MA 02118 | 2020-07-16 |
| 1669094777 | German Eduardo Velez | Student in an Organized Health Care Education/Training Program | One Boston Medical Center Place Boston Medical Center, Boston, MA 02118 | 2020-05-12 |
| 1255969895 | Isabela Medeiros Heringer Pereira | Student in an Organized Health Care Education/Training Program | 670 Albany Stree, 4th Floor, Boston, MA 02118 | 2020-03-30 |
| 1033746466 | Karan Sunil Hingorani | Student in an Organized Health Care Education/Training Program | Shapiro Primary Care, 725 Albany Street, Precepting Room, Boston, MA 02118 | 2020-03-25 |
| 1326672791 | Azza Ahmed | Dentist | 635 Albany St. G-744, Boston, MA 02118 | 2020-02-25 |
| 1538707401 | Jane Margolis | Social Worker | 840 Harrison Ave., Dowling 2 South, Boston, MA 02118 | 2019-12-11 |
| 1871134833 | Supontep Teerakanok | Dentist | Henry Goldman School of Dental Medicine, 635 Albany St, Boston, MA 02118 | 2019-10-01 |
| 1750939583 | Qasim Silman Ajmi | Orthopaedic Surgery | Department of Orthopaedic Surgery Boston Medical Center, 850 Harrison Ave Dowling 2 North, Boston, MA 02118 | 2019-08-26 |
| 1922655539 | Jami Ryan Pollard | Physician Assistant | 840 Harrison Avenue, Menino Building, Boston, MA 02118 | 2019-08-20 |
| Find all providers in zip 02118 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386165470 | Malik Bilal Ahmed | Internal Medicine | 800 Washington Street Mailbox #315, Boston, MA 02111 | 2017-06-29 |
| 1760867667 | Chi Hong Chau | Internal Medicine | 400 Brookline Ave Apt 15a, Boston, MA 02215-5406 | 2015-07-21 |
| 1972916039 | Adam T Phillips | Internal Medicine | 185 Pilgrim Rd Fl Baker4, Boston, MA 02215 | 2014-06-06 |
| 1760809818 | Subhasree Panchangam | Internal Medicine | 830 Harrison Ave Bldg 3500, Boston, MA 02118-2905 | 2014-03-26 |
| 1124463609 | Gaurav Gulati | Internal Medicine | 800 Washington St # 315, Boston, MA 02111-1552 | 2013-05-09 |
| 1255600300 | Steward Medical Group, Inc | Internal Medicine | 500 Boylston St, Boston, MA 02116-3740 | 2011-12-19 |
| 1942586334 | Nina Ghosh | Internal Medicine | 75 Peterborough St, Suite 401, Boston, MA 02215-4311 | 2011-10-29 |
| 1841515509 | Chris Wei-sen Pan | Internal Medicine | 1597 Washington St, Apt 503, Boston, MA 02118-1915 | 2010-04-06 |
| 1730349853 | Gerald J. Doyle, M.d., P.C. | Internal Medicine | 3 Hawthorne Pl, Boston, MA 02114-2334 | 2008-06-12 |
| 1639369713 | Aram V Chobanian | Internal Medicine | Boston Univ. School of Med., 715 Albany Street, Boston, MA 02118 | 2007-07-26 |
| 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.