INNOVATIVE MEDICINE, PC (NPI# 1154653921) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1154653921 |
| Entity Type | Organization |
| Organization Name | INNOVATIVE MEDICINE, PC |
| Practice Address |
70 Parker Hill Ave Suite 3406 Roxbury Crossing MA 02120-3224 |
| Practice Telephone | 6172322003 |
| Practice Fax Number | 6179750768 |
| Mailing Telephone | 6172322003 |
| Mailing Fax Number | 6179750768 |
| Enumeration Date | 2010-02-04 |
| Last Update Date | 2010-02-04 |
| Authorized Official Name | MR. GERALD C BOUSQUET (PRESIDENT) |
| Authorized Official Telephone | 6172322003 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
Allopathic & Osteopathic Physicians |
| Street Address |
70 PARKER HILL AVE SUITE 3406 |
| City | ROXBURY CROSSING |
| State | MA |
| Zip Code | 02120-3224 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083244735 | Alicia Hoffman | Occupational Therapist | 71 Alleghany Street, Boston, MA 02120 | 2020-01-22 |
| 1376193110 | Katherine Wiley | Student in an Organized Health Care Education/Training Program | 71 Allegheny Street, Boston, MA 02120 | 2019-09-13 |
| 1073171971 | Kyana Figueroa | Community/Behavioral Health | 4 Sussex St, Roxbury, MA 02120 | 2019-06-05 |
| 1851870992 | Robert Kevin Moreland | Radiology | 75 Francis Street, Brigham and Women's Hospital, Boston, MA 02120 | 2018-08-09 |
| 1811424005 | Christopher Lim | Student in an Organized Health Care Education/Training Program | 1620 Tremont St, One Brigham Circle, Radiology Administration, Boston, MA 02120 | 2017-05-18 |
| 1609328178 | Nikhil A Sangave | Pharmacist | 1290 Tremont St Fl 3, Boston, MA 02120 | 2016-10-31 |
| 1417232968 | Hrc Corp Inc | Pharmacy | 201 Humboldt Avenue, Dorchester, MA 02120 | 2011-10-17 |
| 1689957722 | Hrd Corp, Inc | Pharmacy | 201 Humboldt Ave, Dorchester, MA 02120 | 2011-09-26 |
| 1841580453 | Alessandro Villa | Dentist | 1620 Tremont Street, Suite Bc-3-028, Division of Oral Medicine & Dentistry Bwh, Boston, MA 02120 | 2011-04-15 |
| 1043446859 | Sara King | Internal Medicine | 1290 Tremont Street, Boston, MA 02120 | 2009-06-08 |
| Find all providers in zip 02120 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://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 |
|---|---|---|---|---|
| 1386275444 | Grace Medical PC | Internal Medicine | 16 Ledge Hill St, Randolph, MA 02368-3514 | 2020-01-28 |
| 1588154041 | Ralph Nader | Internal Medicine | 72 East Concord St, Collamore Suite 29, Boston, MA 02118 | 2018-05-10 |
| 1184122905 | Claire Avillach | Internal Medicine | 650 Albany St Rm 540, Boston, MA 02118-2518 | 2018-01-26 |
| 1457880213 | Kidney Care and Transplant Services of New England, PC | Internal Medicine | 51 Locust St Ste 3, Northampton, MA 01060-2045 | 2017-06-06 |
| 1609263888 | Naveed Ashfaq | Internal Medicine | 148 Green St, Foxboro, MA 02035-2869 | 2015-04-24 |
| 1043612823 | New England Nephrology Associates, Pllc | Internal Medicine | 263 Huntington Ave # 232, Boston, MA 02115-4506 | 2014-09-23 |
| 1215345178 | Loulwa Alsharhan | Internal Medicine | 650 Albany St Fl 5, Boston, MA 02118-2518 | 2014-07-23 |
| 1639324791 | Patricia A Suzman | Internal Medicine | 87 Beacon St, Boston, MA 02108-3323 | 2008-11-17 |
| 1497922439 | Harald Sinclair Mackenzie | Internal Medicine | 422b Monument St, Concord, MA 01742-1810 | 2008-05-09 |
| 1629256680 | Tal H Kopel | Internal Medicine | 650 Albany St, Renal Section, Rm 504, Boston, MA 02118-2518 | 2008-02-01 |
| Find all providers with the same taxonomy | ||||
| City | ROXBURY CROSSING |
| Zip Code | 02120 |
Please comment or provide details below to improve the information on INNOVATIVE MEDICINE, PC.
| 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.