| Smg Compass | |
|
500 Boylston St Boston MA 02116-3740 | |
| (615) 467-4158 | |
| (615) 467-1267 |
| Full Name | Smg Compass |
|---|---|
| Speciality | Internal Medicine |
| Location | 500 Boylston St, Boston, Massachusetts |
| Authorized Official Name and Position | Michael Callum (CEO) |
| Authorized Official Contact | 6174194702 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Smg Compass 500 Boylston St Boston MA 02116-3740 Ph: (617) 419-4700 | Smg Compass 500 Boylston St Boston MA 02116-3740 Ph: (615) 467-4158 |
| NPI Number | 1255600300 |
|---|---|
| Provider Enumeration Date | 12/19/2011 |
| Last Update Date | 08/13/2020 |
| Medicare PECOS PAC ID | 2860688728 |
|---|---|
| Medicare Enrollment ID | O20120430000164 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255600300 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 207RC0000X | Internal Medicine - Cardiovascular Disease | (* (Not Available)) | Secondary |
| Provider Name | Veena Molagavalli |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487600979 PECOS PAC ID: 8527961770 Enrollment ID: I20040127001007 |
| Provider Name | Mrinal S. Mali |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1023055720 PECOS PAC ID: 7911997325 Enrollment ID: I20040517001204 |
| Provider Name | Andrew Koslow |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1083651723 PECOS PAC ID: 5991788580 Enrollment ID: I20040614000042 |
| Provider Name | Bruce M Weinstein |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396793543 PECOS PAC ID: 6507843208 Enrollment ID: I20040701000104 |
| Provider Name | Sandra Maguire |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1932183662 PECOS PAC ID: 5395715346 Enrollment ID: I20040728000599 |
| Provider Name | Renee Aversano |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962402255 PECOS PAC ID: 5395716401 Enrollment ID: I20040803000800 |
| Provider Name | Patricia Lopresti |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1962625640 PECOS PAC ID: 4183695828 Enrollment ID: I20040804001696 |
| Provider Name | Susan P Davis |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1043206568 PECOS PAC ID: 6406828854 Enrollment ID: I20040806001160 |
| Provider Name | Alexa P Manickas |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1134105521 PECOS PAC ID: 4284606393 Enrollment ID: I20040810000313 |
| Provider Name | Susan Jordan |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1801844048 PECOS PAC ID: 5991792467 Enrollment ID: I20040816000736 |
| Provider Name | Elizabeth A Benson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1851326862 PECOS PAC ID: 8022086727 Enrollment ID: I20040921000376 |
| Provider Name | Rolina Levin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1558390179 PECOS PAC ID: 1355310293 Enrollment ID: I20040928000935 |
| Provider Name | Jessie L Chai |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871580571 PECOS PAC ID: 8325002041 Enrollment ID: I20041112000833 |
| Provider Name | Oliver H Pomeroy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295720100 PECOS PAC ID: 1951365550 Enrollment ID: I20041115000051 |
| Provider Name | Diane C Horan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992787220 PECOS PAC ID: 9830155225 Enrollment ID: I20041207001083 |
| Provider Name | William Poole |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1396770111 PECOS PAC ID: 0042291114 Enrollment ID: I20041209000076 |
| Provider Name | Mark S Ostrem |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811985633 PECOS PAC ID: 6305803958 Enrollment ID: I20041215000212 |
| Provider Name | Deborah A O'keefe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538159579 PECOS PAC ID: 0244297802 Enrollment ID: I20041215000284 |
| Provider Name | Jonathan Shapiro |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1962483222 PECOS PAC ID: 2264485648 Enrollment ID: I20050225000113 |
| Provider Name | Bret F Coughlin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1487686713 PECOS PAC ID: 9335192418 Enrollment ID: I20050301000580 |
| Provider Name | Stephen V Klein |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1154355212 PECOS PAC ID: 1254384209 Enrollment ID: I20050302000185 |
| Provider Name | Steve Y Lee |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1699709758 PECOS PAC ID: 8527011584 Enrollment ID: I20050302000256 |
| Provider Name | Winny Ou |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023003274 PECOS PAC ID: 0244286235 Enrollment ID: I20050323000332 |
| Provider Name | James P Douglas Steele |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760565444 PECOS PAC ID: 9133175961 Enrollment ID: I20050324000841 |
| Provider Name | Susan E Thomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972513950 PECOS PAC ID: 0840263158 Enrollment ID: I20050329001223 |
| Provider Name | Michael D Achey |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1578574703 PECOS PAC ID: 5193798494 Enrollment ID: I20050405001264 |
| Provider Name | Diane S Messersmith |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841239035 PECOS PAC ID: 0648219303 Enrollment ID: I20050502000923 |
| Provider Name | Jonathan R Ellis |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1932155637 PECOS PAC ID: 4880667187 Enrollment ID: I20050503000907 |
| Provider Name | Ethan B Foxman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1225014731 PECOS PAC ID: 1355338799 Enrollment ID: I20050509000850 |
| Provider Name | Brian B Bloom |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164403580 PECOS PAC ID: 6406898154 Enrollment ID: I20050524000364 |
| Provider Name | Kevin Broderick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013954759 PECOS PAC ID: 1153363155 Enrollment ID: I20050601000130 |
| Provider Name | David L Zimmerman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1891701777 PECOS PAC ID: 1153365028 Enrollment ID: I20050613000742 |
| Provider Name | Gail F Williams |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1134147614 PECOS PAC ID: 4587609433 Enrollment ID: I20050622000415 |
| Provider Name | Eileen R Comeau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164450979 PECOS PAC ID: 0446296255 Enrollment ID: I20050701000577 |
| Provider Name | Nancy Peplau |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1073544144 PECOS PAC ID: 5597795898 Enrollment ID: I20050816001186 |
| Provider Name | Karen J Allard |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194719245 PECOS PAC ID: 0143250977 Enrollment ID: I20050822000180 |
| Provider Name | Sonali A Khond |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023089885 PECOS PAC ID: 8325064447 Enrollment ID: I20051018001126 |
| Provider Name | Ersan Yalcin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023065281 PECOS PAC ID: 7517971948 Enrollment ID: I20060206000446 |
| Provider Name | Nancy T. Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023043932 PECOS PAC ID: 3072528439 Enrollment ID: I20060207000633 |
| Provider Name | Suzanne C Leone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457386468 PECOS PAC ID: 0143235424 Enrollment ID: I20060207000868 |
| Provider Name | Marina Freyman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1215916408 PECOS PAC ID: 8921014440 Enrollment ID: I20060221000618 |
| Provider Name | Edward F Hassan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396784385 PECOS PAC ID: 7416920715 Enrollment ID: I20060405000621 |
| Provider Name | Joyce R Child |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1003822529 PECOS PAC ID: 0840209607 Enrollment ID: I20060406000447 |
| Provider Name | Malgorzata E Cywinska |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1497771091 PECOS PAC ID: 6305855081 Enrollment ID: I20060406000686 |
| Provider Name | Dyan Bhatia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376590950 PECOS PAC ID: 1254304553 Enrollment ID: I20060801000068 |
| Provider Name | Samar Choubah |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1588698245 PECOS PAC ID: 5991738122 Enrollment ID: I20060818000055 |
| Provider Name | Hadeer M Shaikhly |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477537991 PECOS PAC ID: 4385668243 Enrollment ID: I20060926000171 |
| Provider Name | John Mapili |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1952317018 PECOS PAC ID: 9830195841 Enrollment ID: I20070102000126 |
| Provider Name | Michelle J Beaupre |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851303655 PECOS PAC ID: 3870684376 Enrollment ID: I20070814000016 |
| Provider Name | Joanne Silvia |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1568575876 PECOS PAC ID: 0244323970 Enrollment ID: I20070911000374 |
| Provider Name | Dahlia S. Riad |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396736708 PECOS PAC ID: 1850364167 Enrollment ID: I20070918000342 |
| Provider Name | Shikha Merchia |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1689648461 PECOS PAC ID: 6608842018 Enrollment ID: I20071009000873 |
| Provider Name | William T Bennett |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1528041365 PECOS PAC ID: 2567487424 Enrollment ID: I20071023000521 |
| Provider Name | Debra A Landry |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760519979 PECOS PAC ID: 3971683129 Enrollment ID: I20071231000377 |
| Provider Name | Shuchi Gupta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487642732 PECOS PAC ID: 8426130477 Enrollment ID: I20080129000636 |
| Provider Name | John Cavallo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619914322 PECOS PAC ID: 5092788398 Enrollment ID: I20080225000200 |
| Provider Name | Yevgeniy F Drakhlin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487601118 PECOS PAC ID: 0345349288 Enrollment ID: I20080408000782 |
| Provider Name | Elizabeth Levine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1962412957 PECOS PAC ID: 5799884631 Enrollment ID: I20080409000023 |
| Provider Name | Beth A Cerce |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386668796 PECOS PAC ID: 5890894737 Enrollment ID: I20080409000025 |
| Provider Name | Julia Swartz |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1134154149 PECOS PAC ID: 6103903638 Enrollment ID: I20080409000091 |
| Provider Name | Susan G Milliken |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912991167 PECOS PAC ID: 3274612916 Enrollment ID: I20080506000480 |
| Provider Name | Yelena Levin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225056708 PECOS PAC ID: 2860465168 Enrollment ID: I20080522000158 |
| Provider Name | Kasia Filipek Moskal |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1982702957 PECOS PAC ID: 4284710898 Enrollment ID: I20080605000829 |
| Provider Name | Lisa Larsson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326029638 PECOS PAC ID: 7113092149 Enrollment ID: I20080826000428 |
| Provider Name | Laura V Romo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114917275 PECOS PAC ID: 3870660780 Enrollment ID: I20080918000357 |
| Provider Name | Dhrumil Shah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194985846 PECOS PAC ID: 5395812606 Enrollment ID: I20080927000161 |
| Provider Name | Tammy J Boecher |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1639216138 PECOS PAC ID: 8729146063 Enrollment ID: I20081015000391 |
| Provider Name | Baljinder Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1760660492 PECOS PAC ID: 2062571706 Enrollment ID: I20081110000428 |
| Provider Name | Colleen H Daniels |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356537807 PECOS PAC ID: 7012077951 Enrollment ID: I20081121000188 |
| Provider Name | Heather Daniel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538377908 PECOS PAC ID: 3678636578 Enrollment ID: I20090120000054 |
| Provider Name | Shaohua Deng |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174760326 PECOS PAC ID: 5294899738 Enrollment ID: I20090129000067 |
| Provider Name | John M King |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790771269 PECOS PAC ID: 3971660556 Enrollment ID: I20090326000101 |
| Provider Name | Marcin Sprycha |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841455136 PECOS PAC ID: 5991850224 Enrollment ID: I20090909000668 |
| Provider Name | Colleen Silva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508192303 PECOS PAC ID: 3072654672 Enrollment ID: I20100105000155 |
| Provider Name | Gregory R Seiler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306827274 PECOS PAC ID: 0840369450 Enrollment ID: I20100219000501 |
| Provider Name | Marcy B Hersh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215918172 PECOS PAC ID: 5698800944 Enrollment ID: I20100312000081 |
| Provider Name | Michael D Klein |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619065687 PECOS PAC ID: 2264624261 Enrollment ID: I20101008000787 |
| Provider Name | Eric D Wallace |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154434488 PECOS PAC ID: 4880782507 Enrollment ID: I20101105000371 |
| Provider Name | Nora Yousefzadeh Grunin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1932367778 PECOS PAC ID: 3072702547 Enrollment ID: I20110114000049 |
| Provider Name | Prasanta K Karak |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1871599092 PECOS PAC ID: 6406830967 Enrollment ID: I20110201000436 |
| Provider Name | Marlene Cantor |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1861524704 PECOS PAC ID: 6002096781 Enrollment ID: I20110214000009 |
| Provider Name | Jennifer L Richardson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1083846760 PECOS PAC ID: 0648451393 Enrollment ID: I20110301000144 |
| Provider Name | Michael T Oloughlin |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1881670750 PECOS PAC ID: 4789588500 Enrollment ID: I20110307000641 |
| Provider Name | Anal C Patel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194733329 PECOS PAC ID: 6002810843 Enrollment ID: I20110315000266 |
| Provider Name | Reuben Rock |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912983263 PECOS PAC ID: 9234033051 Enrollment ID: I20110322000443 |
| Provider Name | Victoria Grace |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1679891246 PECOS PAC ID: 5991988131 Enrollment ID: I20110324000612 |
| Provider Name | Gabrielle E Mahoney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1619272366 PECOS PAC ID: 9335323047 Enrollment ID: I20110405000063 |
| Provider Name | Werner Rosshirt |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1164408357 PECOS PAC ID: 1759285570 Enrollment ID: I20110428000112 |
| Provider Name | William J Glucksman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1720064249 PECOS PAC ID: 5799689501 Enrollment ID: I20110527000458 |
| Provider Name | John P Volpe |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1295711125 PECOS PAC ID: 6800790627 Enrollment ID: I20110527000483 |
| Provider Name | Harpreet S Baweja |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1942227913 PECOS PAC ID: 8224033238 Enrollment ID: I20110601000539 |
| Provider Name | Bruce P Arose |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619952603 PECOS PAC ID: 2365346178 Enrollment ID: I20110602000265 |
| Provider Name | Gregory T Turner |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1194740308 PECOS PAC ID: 8527071125 Enrollment ID: I20110615000252 |
| Provider Name | Glenn Meunier |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1912204686 PECOS PAC ID: 9133307705 Enrollment ID: I20110630000025 |
| Provider Name | Ryan W Kaliney |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1497977268 PECOS PAC ID: 4486788643 Enrollment ID: I20110714000217 |
| Provider Name | Gregory L Wrubel |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1265738496 PECOS PAC ID: 3971771924 Enrollment ID: I20110902000415 |
| Provider Name | Douglas D Montgomery |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1477539484 PECOS PAC ID: 4880598606 Enrollment ID: I20110919000667 |
| Provider Name | Ilana Warsofsky |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1508188228 PECOS PAC ID: 4284807215 Enrollment ID: I20111107000718 |
| Provider Name | Elizabeth Flowers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386926517 PECOS PAC ID: 2264606243 Enrollment ID: I20111201000512 |
| Provider Name | Steven Sussman |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1568448710 PECOS PAC ID: 2466356282 Enrollment ID: I20111202000016 |
| Provider Name | Thomas H Farquhar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1902851025 PECOS PAC ID: 9739119843 Enrollment ID: I20111208000577 |
| Provider Name | Avni Chudgar |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1427180819 PECOS PAC ID: 4082705835 Enrollment ID: I20120412000309 |
| Provider Name | Timothy J Herbst |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912290883 PECOS PAC ID: 0749468478 Enrollment ID: I20120620000792 |
| Provider Name | Heather Vanderveldt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063791937 PECOS PAC ID: 3678729654 Enrollment ID: I20120807000425 |
| Provider Name | Jenny W Wong |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386993152 PECOS PAC ID: 7911159652 Enrollment ID: I20121204000319 |
| Provider Name | George Vardoulias |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750689840 PECOS PAC ID: 2466601174 Enrollment ID: I20121217000375 |
| Provider Name | Heather J Losee |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1467754333 PECOS PAC ID: 0143474858 Enrollment ID: I20130205000506 |
| Provider Name | Susan Sanford |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962754663 PECOS PAC ID: 8123264546 Enrollment ID: I20130409000411 |
| Provider Name | Natalie J Paris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770829418 PECOS PAC ID: 3072759240 Enrollment ID: I20130412000128 |
| Provider Name | Elizabeth H Tsai |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700105293 PECOS PAC ID: 6507047719 Enrollment ID: I20130718000082 |
| Provider Name | Akash D Patel |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609032580 PECOS PAC ID: 9537212964 Enrollment ID: I20130826000694 |
| Provider Name | Jeffrey J Rock |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1417958158 PECOS PAC ID: 5890865281 Enrollment ID: I20130826000740 |
| Provider Name | David B. Blonder |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1841466430 PECOS PAC ID: 8729235049 Enrollment ID: I20131018000024 |
| Provider Name | Karen J Marshall |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710324470 PECOS PAC ID: 2264667898 Enrollment ID: I20131106001229 |
| Provider Name | Glynelle White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841538543 PECOS PAC ID: 6800025891 Enrollment ID: I20140218000375 |
| Provider Name | Ashley Simoni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801222831 PECOS PAC ID: 3577793801 Enrollment ID: I20140305001389 |
| Provider Name | Ruth A Sotelo |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1982724423 PECOS PAC ID: 8426289752 Enrollment ID: I20140328001675 |
| Provider Name | Philip A Dinauer |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922091941 PECOS PAC ID: 8426035973 Enrollment ID: I20140702001103 |
| Provider Name | Patrick R Duffy |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1922258532 PECOS PAC ID: 9234352246 Enrollment ID: I20140716002591 |
| Provider Name | Jared Martillotti |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1437385341 PECOS PAC ID: 3274759089 Enrollment ID: I20140730002295 |
| Provider Name | Elyse Plante |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255754644 PECOS PAC ID: 1456579010 Enrollment ID: I20140825001001 |
| Provider Name | Robert L Hynecek |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1528221645 PECOS PAC ID: 3375785488 Enrollment ID: I20140909000865 |
| Provider Name | Amy Heath |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710137914 PECOS PAC ID: 6103046370 Enrollment ID: I20141010000698 |
| Provider Name | Michaela A Mamary |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740600477 PECOS PAC ID: 3779809355 Enrollment ID: I20150225000925 |
| Provider Name | Kaitlin Yogel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326457946 PECOS PAC ID: 1759608367 Enrollment ID: I20150319000796 |
| Provider Name | Marianne Elisabeth Rivard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437553823 PECOS PAC ID: 5395063325 Enrollment ID: I20150423000343 |
| Provider Name | Mary R Shoemaker |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1912121476 PECOS PAC ID: 1951360809 Enrollment ID: I20150804003804 |
| Provider Name | Zombor Zoltani |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1114247889 PECOS PAC ID: 8921221367 Enrollment ID: I20150804005366 |
| Provider Name | Kristen Moore Kowalski |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487036257 PECOS PAC ID: 5496063570 Enrollment ID: I20151009001716 |
| Provider Name | Imane T Bentahar |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245488105 PECOS PAC ID: 9133297880 Enrollment ID: I20151019000755 |
| Provider Name | Viviane Maria Fornasaro-donahue |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1841677291 PECOS PAC ID: 5799095089 Enrollment ID: I20151117002834 |
| Provider Name | Amanda C Costa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841541109 PECOS PAC ID: 6608091327 Enrollment ID: I20160108002202 |
| Provider Name | Sean E Kern |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093109118 PECOS PAC ID: 4183926983 Enrollment ID: I20160112000274 |
| Provider Name | Michelle Monahan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255700167 PECOS PAC ID: 3476859455 Enrollment ID: I20160317001180 |
| Provider Name | Sean M Richardson |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1174816003 PECOS PAC ID: 7911290184 Enrollment ID: I20160727000824 |
| Provider Name | Pranav O Oza |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1780810572 PECOS PAC ID: 0840448361 Enrollment ID: I20160802001352 |
| Provider Name | Tara A Doherty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205230455 PECOS PAC ID: 2769776467 Enrollment ID: I20160803001060 |
| Provider Name | Lauren L Maranian |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700270238 PECOS PAC ID: 1658668280 Enrollment ID: I20160927000114 |
| Provider Name | Hollie A O'bryan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104278704 PECOS PAC ID: 5890074280 Enrollment ID: I20161107001602 |
| Provider Name | Michelle Morse |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1528402070 PECOS PAC ID: 2860771144 Enrollment ID: I20161108002602 |
| Provider Name | Shanshan Bao |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1912135211 PECOS PAC ID: 3476847989 Enrollment ID: I20171009002828 |
| Provider Name | Kara Birch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750893582 PECOS PAC ID: 1456619568 Enrollment ID: I20171219002215 |
| Provider Name | Keri Reardon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790223501 PECOS PAC ID: 9133480718 Enrollment ID: I20180222000041 |
| Provider Name | Heather L Hartigan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649753302 PECOS PAC ID: 6901140508 Enrollment ID: I20181210000933 |
| Provider Name | Rebecca L Smith |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063974368 PECOS PAC ID: 7113250069 Enrollment ID: I20190607000158 |
| Provider Name | Melissa Bresnahan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831658061 PECOS PAC ID: 7214261668 Enrollment ID: I20190619000808 |
| Provider Name | Joseph A Lembo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1619312006 PECOS PAC ID: 3971855859 Enrollment ID: I20190717001007 |
| Provider Name | Justine M Malone |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730739947 PECOS PAC ID: 3072945351 Enrollment ID: I20191107002994 |
| Provider Name | Allison Castino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1295396703 PECOS PAC ID: 3870925878 Enrollment ID: I20191113000931 |
| Provider Name | Gregory K Russo |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1770502361 PECOS PAC ID: 3678577970 Enrollment ID: I20191113003019 |
| Provider Name | Johanna M Chang |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1356570980 PECOS PAC ID: 4789801051 Enrollment ID: I20191231001990 |
| Provider Name | Paul Comerford |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184061723 PECOS PAC ID: 7719238690 Enrollment ID: I20200207002098 |
| Provider Name | Katelyn Michelle Pento |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164067831 PECOS PAC ID: 0143658484 Enrollment ID: I20200319001094 |
| Provider Name | Jessica L Dasilva |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043857782 PECOS PAC ID: 1254761885 Enrollment ID: I20200423000530 |
| Provider Name | Amy Christine Noel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1750935151 PECOS PAC ID: 3072944289 Enrollment ID: I20200501002783 |
| Provider Name | Lindsey Williams |
|---|---|
| Provider Type | Practitioner - Diagnostic Radiology |
| Provider Identifiers | NPI Number: 1033452321 PECOS PAC ID: 0840541470 Enrollment ID: I20201117001682 |
| Provider Name | Kimberly Coto |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528541653 PECOS PAC ID: 7416365861 Enrollment ID: I20210423000368 |
| Provider Name | Mary Louise Dadura |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043715931 PECOS PAC ID: 0446649693 Enrollment ID: I20211110001250 |
Rong J Guan, Md Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 30 Kneeland St Fl 5, Boston, MA 02111 Phone: 617-290-9881 Fax: 617-350-6555 | |
Fenway Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1340 Boylston St, Boston, MA 02215 Phone: 617-927-4880 | |
Robert H. Wu. Md, Pc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 65 Harrison Ave Ste 308, Boston, MA 02111 Phone: 617-338-9889 | |
Barbara Mcinnis House Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 780 Albany St, Boston, MA 02118 Phone: 857-654-1000 Fax: 857-654-1100 | |
Pratt Medical Group, Inc - Gastroenterology Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 800 Washington St, Box 1013, Boston, MA 02111 Phone: 617-636-5000 | |
Pjtrains Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 14 Newbury St Ste 4, Boston, MA 02116 Phone: 857-205-2759 | |
Mhg Physician Services - Michigan Pllc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 500 Harrison Ave, Boston, MA 02118 Phone: 855-340-4663 |