| Roger Breitbart, MD | |
|
300 Longwood Ave, Boston, MA 02115-5724 | |
| (617) 355-6793 | |
| Not Available |
| Full Name | Roger Breitbart |
|---|---|
| Gender | Male |
| Speciality | Pediatrics - Pediatric Cardiology |
| Location | 300 Longwood Ave, Boston, Massachusetts |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174597983 | NPI | - | NPPES |
| 1098686 | Medicaid | NY | |
| 003066653 | Medicaid | CT | |
| 30002638 | Medicaid | NH | |
| 3036791 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2080P0202X | Pediatrics - Pediatric Cardiology | 53193 (Massachusetts) | Primary |
| Entity Name | Boston Childrens Heart Foundation Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1982680922 PECOS PAC ID: 8729071675 Enrollment ID: O20040406001030 |
| Mailing Address | Practice Location Address |
|---|---|
| Roger Breitbart, MD Po Box 845628, Boston, MA 02284-5628 Ph: (617) 355-6793 | Roger Breitbart, MD 300 Longwood Ave, Boston, MA 02115-5724 Ph: (617) 355-6793 |
Puja Banka, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 300 Longwood Ave, Bader 203, Boston, MA 02115 Phone: 617-355-6363 | |
Angela M. Jacques, MD Pediatrics Medicare: Medicare Enrolled Practice Location: Massachusetts General Hospital, 55 Fruit St., Boston, MA 02114 Phone: 617-726-2066 | |
Dr. Elizabeth S Taglauer, M.D., PH.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 300 Longwood Ave, Boston, MA 02115 Phone: 617-355-6000 | |
Cailyn Hereen Rood, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 300 Longwood Ave, Boston, MA 02115 Phone: 617-355-6000 | |
Dr. Alon Peltz, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 300 Longwood Ave, Boston, MA 02115 Phone: 617-355-6000 | |
Miki Nishitani, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 300 Longwood Ave, Boston, MA 02115 Phone: 617-355-6000 | |
Vickren Pillay, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 300 Longwood Ave, Boston, MA 02115 Phone: 617-355-6000 |