| Boston University Family Medicine, Inc. | |
|
1 Boston Medical Ctr Pl Boston MA 02118-2908 | |
| (617) 414-2080 | |
| (617) 414-2090 |
| Full Name | Boston University Family Medicine, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 1 Boston Medical Ctr Pl, Boston, Massachusetts |
| Authorized Official Name and Position | Stephen A. Wilson (PRESIDENT) |
| Authorized Official Contact | 6174142080 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Boston University Family Medicine, Inc. 960 Massachusetts Ave Fl 2 Boston MA 02118-2690 Ph: () - | Boston University Family Medicine, Inc. 1 Boston Medical Ctr Pl Boston MA 02118-2908 Ph: (617) 414-2080 |
| NPI Number | 1134166390 |
|---|---|
| Provider Enumeration Date | 05/31/2006 |
| Last Update Date | 12/20/2023 |
| Medicare PECOS PAC ID | 0446154074 |
|---|---|
| Medicare Enrollment ID | O20031125000010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134166390 | NPI | - | NPPES |
| 110072644A | Medicaid | MA | |
| 3114929 | Medicaid | NH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jeffrey F Markuns |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1184698474 PECOS PAC ID: 2163328907 Enrollment ID: I20031211000295 |
| Provider Name | Cheryl A Mcsweeney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1811976897 PECOS PAC ID: 8325934078 Enrollment ID: I20040227000573 |
| Provider Name | Charles T Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134107436 PECOS PAC ID: 4183614654 Enrollment ID: I20040517000162 |
| Provider Name | Avra L Goldman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821064726 PECOS PAC ID: 1850381344 Enrollment ID: I20040517000304 |
| Provider Name | Christopher S Manasseh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407820673 PECOS PAC ID: 7113917634 Enrollment ID: I20040517000538 |
| Provider Name | Laura N Goldman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205800455 PECOS PAC ID: 5597755934 Enrollment ID: I20040517000749 |
| Provider Name | Mari J Bentley |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043299027 PECOS PAC ID: 2860476629 Enrollment ID: I20040617001035 |
| Provider Name | Rachel K Mott Keis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447239439 PECOS PAC ID: 7517943566 Enrollment ID: I20040629000731 |
| Provider Name | Aram Kaligian |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912970591 PECOS PAC ID: 0941280044 Enrollment ID: I20040721000080 |
| Provider Name | Nidhi K Lal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1114990652 PECOS PAC ID: 0244208395 Enrollment ID: I20050131000657 |
| Provider Name | Karin Leschly |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1013996099 PECOS PAC ID: 3274578745 Enrollment ID: I20050624000428 |
| Provider Name | Richard R Ress |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1265472799 PECOS PAC ID: 1557391414 Enrollment ID: I20050819000572 |
| Provider Name | Kristen H Goodell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134329691 PECOS PAC ID: 4587755244 Enrollment ID: I20070809000394 |
| Provider Name | Evelyne Chiakpo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619942075 PECOS PAC ID: 4486661402 Enrollment ID: I20070912000555 |
| Provider Name | Heather H Miselis |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1437349529 PECOS PAC ID: 5890881726 Enrollment ID: I20071023000499 |
| Provider Name | Thomas C Hines |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235103219 PECOS PAC ID: 2860562097 Enrollment ID: I20080530000524 |
| Provider Name | Jennifer L Pfau |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1134263502 PECOS PAC ID: 3375611858 Enrollment ID: I20081010000325 |
| Provider Name | Katherine A Gergen Barnett |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023209129 PECOS PAC ID: 7618036047 Enrollment ID: I20081030000230 |
| Provider Name | Lilia H Cardenas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841406964 PECOS PAC ID: 7113063868 Enrollment ID: I20091009000269 |
| Provider Name | Alla Borisovna Sherer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427383637 PECOS PAC ID: 6800935388 Enrollment ID: I20091121000021 |
| Provider Name | Anita L Kostecki |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295710119 PECOS PAC ID: 0244370740 Enrollment ID: I20091214000640 |
| Provider Name | Anne Theresa Dwyer-wilmer |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1619170255 PECOS PAC ID: 5799978946 Enrollment ID: I20101020000163 |
| Provider Name | Lana Habash |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1316911399 PECOS PAC ID: 2264620731 Enrollment ID: I20101228000344 |
| Provider Name | Judith P. Lytle |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1437106226 PECOS PAC ID: 0547445686 Enrollment ID: I20110504000682 |
| Provider Name | Jennifer Meade Proietti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184925026 PECOS PAC ID: 1456522416 Enrollment ID: I20110922000587 |
| Provider Name | Elizabeth E Ferrenz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770724296 PECOS PAC ID: 5698947539 Enrollment ID: I20111018000833 |
| Provider Name | Kuon S. Lo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1730341686 PECOS PAC ID: 8123282050 Enrollment ID: I20121217000208 |
| Provider Name | Amola Shertukde Bhakta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346560901 PECOS PAC ID: 1456594142 Enrollment ID: I20130828000350 |
| Provider Name | Kyu C. Kim |
|---|---|
| Provider Type | Practitioner - Rheumatology |
| Provider Identifiers | NPI Number: 1942442405 PECOS PAC ID: 5092949420 Enrollment ID: I20131017001561 |
| Provider Name | Pamela J Francoeur |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1982033825 PECOS PAC ID: 3173751419 Enrollment ID: I20140114001053 |
| Provider Name | Nathan C Cardoos |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1083908685 PECOS PAC ID: 8022322031 Enrollment ID: I20150805006507 |
| Provider Name | Marissa R Hamrick |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1386905685 PECOS PAC ID: 9335371426 Enrollment ID: I20150922003338 |
| Provider Name | Jennifer L Trieu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992026777 PECOS PAC ID: 3173764271 Enrollment ID: I20151117000145 |
| Provider Name | Lidya Helen Wlasiuk |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003175910 PECOS PAC ID: 7214169556 Enrollment ID: I20151118000900 |
| Provider Name | Aileen K Roman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760851620 PECOS PAC ID: 5597060756 Enrollment ID: I20160225001439 |
| Provider Name | Kirsten E Austad |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1447593322 PECOS PAC ID: 2163654088 Enrollment ID: I20160613001509 |
| Provider Name | Charlene Julien |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790148864 PECOS PAC ID: 2365733466 Enrollment ID: I20160621001252 |
| Provider Name | Paul Long |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225473226 PECOS PAC ID: 7719119429 Enrollment ID: I20160721000603 |
| Provider Name | Lauren E. Scott |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194179234 PECOS PAC ID: 8628364957 Enrollment ID: I20160912002498 |
| Provider Name | Aimee F Williams |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538505771 PECOS PAC ID: 1557593605 Enrollment ID: I20160928000822 |
| Provider Name | Amanda Eva Deloureiro |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1598008518 PECOS PAC ID: 5193957744 Enrollment ID: I20161020000609 |
| Provider Name | Mekkin E Lynch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245674985 PECOS PAC ID: 4688952781 Enrollment ID: I20161025000315 |
| Provider Name | Keri D Sewell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912240441 PECOS PAC ID: 2961634290 Enrollment ID: I20161029000200 |
| Provider Name | Marielle C Baldwin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396164877 PECOS PAC ID: 5193943074 Enrollment ID: I20170828002806 |
| Provider Name | Elizabeth A Doran |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1255741856 PECOS PAC ID: 6103044094 Enrollment ID: I20170925000042 |
| Provider Name | Maya Mauch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093129488 PECOS PAC ID: 7810282183 Enrollment ID: I20170925001893 |
| Provider Name | Mary Ann Dakkak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1326313776 PECOS PAC ID: 2668605296 Enrollment ID: I20171017003600 |
| Provider Name | Lindsay Sue Crossan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316463094 PECOS PAC ID: 2860758257 Enrollment ID: I20171120000042 |
| Provider Name | Caroline Slater Mullin |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861802274 PECOS PAC ID: 1759509953 Enrollment ID: I20171201001487 |
| Provider Name | Julia Rogers Wolfe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740799808 PECOS PAC ID: 3072873223 Enrollment ID: I20180207001875 |
| Provider Name | Julia Ann Bartolomeo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1912394297 PECOS PAC ID: 2163739210 Enrollment ID: I20180731001186 |
| Provider Name | Juliana I Castedo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992191167 PECOS PAC ID: 3971818451 Enrollment ID: I20180831000310 |
| Provider Name | Laura T Adam |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619318532 PECOS PAC ID: 6800102559 Enrollment ID: I20181019000458 |
| Provider Name | Katherine May Chambers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881108223 PECOS PAC ID: 2668710104 Enrollment ID: I20190208000579 |
| Provider Name | Stephen M. Marsh |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1528453008 PECOS PAC ID: 0446565394 Enrollment ID: I20190423000207 |
| Provider Name | Katherine R Standish |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306209168 PECOS PAC ID: 4880989045 Enrollment ID: I20190625000899 |
| Provider Name | Kenneth P Grossman |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1104847953 PECOS PAC ID: 3375855000 Enrollment ID: I20190730004398 |
| Provider Name | Claire M. Lyons |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1619327566 PECOS PAC ID: 1557655206 Enrollment ID: I20190806002937 |
| Provider Name | Adi Rattner Nevo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235552415 PECOS PAC ID: 3173818572 Enrollment ID: I20190806003105 |
| Provider Name | Theresa F Clearman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144609793 PECOS PAC ID: 7911210174 Enrollment ID: I20191025001169 |
| Provider Name | Brian T Kroener |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1205220126 PECOS PAC ID: 0840503850 Enrollment ID: I20191030002935 |
| Provider Name | Chandler H Christophe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053773515 PECOS PAC ID: 5890080436 Enrollment ID: I20191104002108 |
| Provider Name | Christopher Ma |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1962814921 PECOS PAC ID: 6204138159 Enrollment ID: I20191202001354 |
| Provider Name | Jeremy T Ng |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1407054380 PECOS PAC ID: 6608069950 Enrollment ID: I20200113000274 |
| Provider Name | Talia Liane Singer-clark |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1982135463 PECOS PAC ID: 8123399128 Enrollment ID: I20200618001259 |
| Provider Name | Stephen A Wilson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679512792 PECOS PAC ID: 1850294000 Enrollment ID: I20201218002121 |
| Provider Name | Sumana Setty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1710417563 PECOS PAC ID: 8820368244 Enrollment ID: I20210510001008 |
| Provider Name | Howard Lanney |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720582406 PECOS PAC ID: 6800146218 Enrollment ID: I20210629002107 |
| Provider Name | Renee M Crichlow |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396731832 PECOS PAC ID: 9133110380 Enrollment ID: I20210803003366 |
| Provider Name | Jennifer J Vanderweele |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841682127 PECOS PAC ID: 9234489691 Enrollment ID: I20210805003095 |
| Provider Name | Carolyn M Arnold |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1093104408 PECOS PAC ID: 6800146333 Enrollment ID: I20210806000529 |
| Provider Name | Heather Ross |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1033614938 PECOS PAC ID: 9436408911 Enrollment ID: I20210826003525 |
| Provider Name | Alyssa Marie Tilhou |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1538553490 PECOS PAC ID: 0345530614 Enrollment ID: I20211102002963 |
| Provider Name | Rohini Rau-murthy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346744349 PECOS PAC ID: 1759631112 Enrollment ID: I20211110000151 |
| Provider Name | Maya Farah |
|---|---|
| Provider Type | Practitioner - Dermatology |
| Provider Identifiers | NPI Number: 1629674221 PECOS PAC ID: 2264824911 Enrollment ID: I20220110001502 |
| Provider Name | Sarah Olofsson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427517200 PECOS PAC ID: 9739415126 Enrollment ID: I20220520000353 |
| Provider Name | Yijia Hu |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1194284240 PECOS PAC ID: 1850625617 Enrollment ID: I20220615001652 |
| Provider Name | Emily L. Geldwert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881154078 PECOS PAC ID: 2668706474 Enrollment ID: I20220818001175 |
| Provider Name | Klive M Forde |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629331772 PECOS PAC ID: 5496970592 Enrollment ID: I20221005002620 |
| Provider Name | Julia M Kirchner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962907568 PECOS PAC ID: 4587066188 Enrollment ID: I20221108001225 |
| Provider Name | Jayme Mendelsohn |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770043374 PECOS PAC ID: 6507291705 Enrollment ID: I20221108002588 |
| Provider Name | Emily Grace Mckeon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1194459826 PECOS PAC ID: 5890165559 Enrollment ID: I20221221003052 |
| Provider Name | Carolyn Phelan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235848029 PECOS PAC ID: 6103296652 Enrollment ID: I20221228001579 |
| Provider Name | Josie Ouellette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063124212 PECOS PAC ID: 8022489913 Enrollment ID: I20230201002124 |
| Provider Name | Joo Hyun Lee |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821619925 PECOS PAC ID: 5991162950 Enrollment ID: I20230606002795 |
| Provider Name | Sam C Gonzalez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881199560 PECOS PAC ID: 1456600782 Enrollment ID: I20230705001910 |
| Provider Name | Mihoko Tanabe |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720615313 PECOS PAC ID: 2668883372 Enrollment ID: I20230801000411 |
| Provider Name | Justin David Alves |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669167185 PECOS PAC ID: 4789045295 Enrollment ID: I20230801000788 |
| Provider Name | Camille Nakita Rivers |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053948927 PECOS PAC ID: 7911318704 Enrollment ID: I20230911002796 |
| Provider Name | Anuka Das |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1285194480 PECOS PAC ID: 4587990981 Enrollment ID: I20230912001369 |
| Provider Name | Gerianne P Connell |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1902434905 PECOS PAC ID: 6204255086 Enrollment ID: I20230920003802 |
| Provider Name | Manuela Noriega |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821557695 PECOS PAC ID: 3476935602 Enrollment ID: I20231003002626 |
| Provider Name | Lily Ann Black |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1609495514 PECOS PAC ID: 7810319621 Enrollment ID: I20231020001509 |
| Provider Name | Daphne A Matthews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992945083 PECOS PAC ID: 3274989264 Enrollment ID: I20231027000100 |
| Provider Name | Sarah Isabella Watler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1578121000 PECOS PAC ID: 3375910284 Enrollment ID: I20240206001308 |
| Provider Name | Peter A Cognetti |
|---|---|
| Provider Type | Practitioner - Sports Medicine |
| Provider Identifiers | NPI Number: 1154814689 PECOS PAC ID: 5294139952 Enrollment ID: I20240530003597 |
| Provider Name | Emily Regier |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548897028 PECOS PAC ID: 0547671216 Enrollment ID: I20240723002947 |
| Provider Name | Cierra Chiyoko Virtue |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841871530 PECOS PAC ID: 4082003744 Enrollment ID: I20240814001005 |
| Provider Name | Meygan J Lackey |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1396326500 PECOS PAC ID: 3173992492 Enrollment ID: I20240819004053 |
| Provider Name | Ife Jaha Tracy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497373799 PECOS PAC ID: 0840739488 Enrollment ID: I20240828000605 |
| Provider Name | Mallika Sabharwal |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1881127629 PECOS PAC ID: 9335476001 Enrollment ID: I20240829001295 |
| Provider Name | Rayyan M Quip |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1366068165 PECOS PAC ID: 3072930221 Enrollment ID: I20241101002645 |
| Provider Name | Amrutha Denduluri |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174290951 PECOS PAC ID: 0042609471 Enrollment ID: I20241122002357 |
| Provider Name | Allison Dana Mika Lukacic |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932737053 PECOS PAC ID: 4587013297 Enrollment ID: I20241204000682 |
| Provider Name | Sara Christine Campedelli |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1265270391 PECOS PAC ID: 8628506953 Enrollment ID: I20250114001267 |
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 | |
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 | |
Boston Health Care For The Homeless Program, Inc. 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 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 | |
Boston Food Allergy Center, Steward Healthcare Network Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 65 Harrison Ave, Suite 201, Boston, MA 02111 Phone: 617-636-8858 Fax: 617-636-8826 |