DR. MIRA KAUTZKY


Address: 15 Parkman St, Suite 645, Wacc, Boston, MA 02114
Phone: 6177240646

DR. MIRA KAUTZKY (NPI# 1972505402) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1972505402
Entity Type Individual
Full Name DR. MIRA KAUTZKY
Credential M.D.
Practice Address 15 Parkman St
Suite 645, Wacc
Boston
MA 02114
Practice Telephone 6177240646
Practice Fax Number 6177240656
Mailing Telephone 6177240646
Mailing Fax Number 6177240656
Enumeration Date 2005-08-15
Last Update Date 2010-07-19
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207R00000X Internal Medicine 242083 MA Allopathic & Osteopathic Physicians
N 207R00000X Internal Medicine MD-070882-L PA Allopathic & Osteopathic Physicians

Office Location

Street Address 15 PARKMAN ST
SUITE 645, WACC
City BOSTON
State MA
Zip Code 02114

Providers in the same location

NPI Name Taxonomy Address Enumeration
1528678646 Lizabeth J Flash Psychiatry & Neurology 15 Parkman St, Boston, MA 02114-3117 2020-08-04
1710513726 Travis Robert Hallett Student in an Organized Health Care Education/Training Program 15 Parkman St, Wacc-6-635, Boston, MA 02114 2020-03-21
1679118780 Loren Hasse Physical Medicine & Rehabilitation 15 Parkman St, Boston, MA 02114-3117 2019-11-12
1891344354 Wallace Leo Frigon Jr. Physical Therapist 15 Parkman St, Boston, MA 02114-3117 2019-09-08
1447818539 Catherine Moore Registered Nurse 15 Parkman St, Boston, MA 02114-3117 2019-06-03
1285197038 Ashley Marie O'brien Physical Therapist 15 Parkman St, Wac 134, Boston, MA 02114-3117 2019-04-09
1386105302 Ayana Robertson Physical Therapist 15 Parkman St, Boston, MA 02114-3117 2019-03-31
1407315765 Griffin Ayaz Tyree Student in an Organized Health Care Education/Training Program 15 Parkman St, Wang 812, Boston, MA 02114-3117 2019-03-17
1962987172 Joshua Connor Torrey Physical Therapist 15 Parkman St, Boston, MA 02114-3117 2018-10-03
1851878037 Abby Farrand Social Worker 15 Parkman St, Boston, MA 02114-3117 2018-07-20
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1588276281 Guoliang Qiao Student in an Organized Health Care Education/Training Program Massachusetts General Hospital, 55 Fruit Street., Boston, MA 02114 2020-08-24
1881223741 Alexander Wesley Zirulnik Student in an Organized Health Care Education/Training Program 55 Fruit St. Boston, Boston, MA 02114 2020-04-03
1376170548 Mia Yu Bothwell Student in an Organized Health Care Education/Training Program Gray Bigelow 730, 55 Fruit Street, Boston, MA 02114 2020-03-26
1225661036 David Dongkyung Kim Student in an Organized Health Care Education/Training Program 6 Whittier Place, Apartment 15b, Boston, MA 02114 2020-02-20
1124651658 Madeleine Sertic Student in an Organized Health Care Education/Training Program Division of Abdominal Imaging, Department of Radiology, 55 Fruit Street, White 270, Boston, MA 02114 2020-02-12
1285274498 Jiuk James Jung Student in an Organized Health Care Education/Training Program 15 Parkman Ave, Wang 4-460, Boston, MA 02114 2020-01-15
1831740448 Jennifer Hughes Physician Assistant 55 Fruit Street, Founders 110, Boston, MA 02114 2019-09-25
1558827220 Aluma Chovel Sella Student in an Organized Health Care Education/Training Program Massgeneral Hospital for Children Main Campus, 55 Fruit Street, Boston, MA 02114 2019-02-18
1083187140 Henry Oliveras Massage Therapist 102 Charles Street, Boston, MA 02114 2019-01-10
1720550031 Nicole M Price Social Worker 29 Staniford St, Boston, MA 02114 2018-12-27
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Taxonomy Information

Taxonomy Code 207R00000X
Grouping Allopathic & Osteopathic Physicians
Classification Internal Medicine

Taxonomy Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1265042832 Rinat Nuriev Internal Medicine 530 Western Ave Apt 404, Boston, MA 02135-1036 2020-08-07
1831726595 James Dotimas Internal Medicine 801 Massachusetts Ave Ste 6c, Boston, MA 02118-2605 2020-03-24
1487291100 Evolvd Health Internal Medicine 85 Brainerd Rd Apt 108, Boston, MA 02134-4529 2019-12-01
1821658709 Jennifer Drummond Internal Medicine 800 Washington St. Gme Office, Boston, MA 02111 2019-06-13
1699237081 Steven Lynn St Peter Internal Medicine 43 Union Park Apt 2, Boston, MA 02118-3702 2019-04-03
1083174478 Kevin Stirling Internal Medicine Shapiro Primary Care 725 Albany Street, 5b/c Precepting Room, Boston, MA 02118 2019-03-21
1477042737 Theofanis Kalathas Internal Medicine 725 Albany Street, Shapiro 5d6, Boston, MA 02118 2018-05-02
1801309521 Firefly Health Internal Medicine 361 Newbury St Fl 5, Boston, MA 02115-2738 2017-11-16
1104346527 Jodian Amor Pinkney Internal Medicine 55 Fruit St # 130, Boston, MA 02114-2621 2017-06-27
1568982502 Priyanka Ballal Internal Medicine 725 Albany Street, Shapiro 586, Boston, MA 02118-2526 2017-06-21
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Competitor

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City BOSTON
Zip Code 02114

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Dataset Information

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.

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