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NPI Code Detail

MEDICARE: BETH ISRAEL DEACONESS MEDICAL CENTER, INC

MEDICARE: BETH ISRAEL DEACONESS MEDICAL CENTER, INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QU0200XUrgent Care Clinic/Center

General Provider Information

NPI Number : 1235662933
Entity Type Code : Organization
Provider Name (Legal Business Name) : BETH ISRAEL DEACONESS MEDICAL CENTER, INC
Provider Business Mailing Address
First Line : 330 BROOKLINE AVE
Second Line :
City : BOSTON
State : MA
Zip : 02215-5400
Country : US
Telephone Number : 617-667-7000
Fax Number :
Provider Business Practice Location Address
First Line : 1000 BROADWAY
Second Line :
City : CHELSEA
State : MA
Zip : 02150-2247
Country : US
Telephone Number : 617-975-6060
Fax Number : 671-975-6151
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : MR. SATISH BHOGADI
Credential :
Telephone Number : 617-785-6619
Provider Enumeration Date : 04/10/2017
Last Update Date : 01/20/2026

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