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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
1282N00000XGeneral Acute Care Hospital

General Provider Information

NPI Number : 1548202641
Entity Type Code : Organization
Provider Name (Legal Business Name) : BETH ISRAEL DEACONESS MEDICAL CENTER, INC.
Provider Business Mailing Address
First Line : 330 BROOKLINE AVE STE FD205B
Second Line :
City : BOSTON
State : MA
Zip : 02215-5400
Country : US
Telephone Number : 617-667-7151
Fax Number : 617-667-7455
Provider Business Practice Location Address
First Line : 330 BROOKLINE AVE
Second Line : ST 207
City : BOSTON
State : MA
Zip : 02215-5400
Country : US
Telephone Number : 617-667-1961
Fax Number : 617-975-5700
Authorized Official
Title or Position : CHIEF FINANCIAL OFFICER
Name : SATISH BHOGADI
Credential :
Telephone Number : 617-785-6619
Provider Enumeration Date : 06/12/2006
Last Update Date : 01/20/2026

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