Dr Rustam K De Vitre, DMD in Boston, MA - Medicare Dentist Provider

Dr Rustam K De Vitre, DMD is a medicare enrolled "Dentist - Prosthodontics" provider in Boston, Massachusetts. His current practice location is 392 Commonwealth Ave, Boston, Massachusetts. You can reach out to his office (for appointments etc.) via phone at (617) 236-5969.

Dr Rustam K De Vitre is licensed to practice in Massachusetts (license number 13701) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1477610269.

Contact Information

	Dr Rustam K De Vitre, DMD
	392 Commonwealth Ave, Boston, MA 02215-2801
	(617) 236-5969
	(617) 424-6265

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Rustam K De Vitre
Gender	Male
Speciality	Dentist - Prosthodontics
Location	392 Commonwealth Ave, Boston, Massachusetts
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1477610269
Provider Enumeration Date: 01/02/2007
Last Update Date: 07/08/2007

Medicare PECOS Information:

PECOS PAC ID: 6103147384
Enrollment ID: I20150601001647

Medical Identifiers

Medical identifiers for Dr Rustam K De Vitre such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1477610269	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1223P0700X	Dentist - Prosthodontics	13701 (Massachusetts)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Rustam K De Vitre is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Rustam K De Vitre, DMD 392 Commonwealth Ave, Boston, MA 02215-2801 Ph: (617) 236-5969	Dr Rustam K De Vitre, DMD 392 Commonwealth Ave, Boston, MA 02215-2801 Ph: (617) 236-5969

Reviews and Comments

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Dr Rustam K De Vitre, DMD - Medicare Dentist in Boston, MA