LAURA MARIE BEVILACQUA MD NPI 1700875507

NPI Information

NPI: 1700875507
Provider Name: LAURA MARIE BEVILACQUA, MD
Classification: Internal Medicine - 207RC0001X
Entity Type: Individual

Specialization: Clinical Cardiac Electrophysiology

PECOS Registration: Yes

Address:
300 LONGWOOD AVE
BOSTON, MA
ZIP 02115
Phone: (617) 355-6793
Get Directions

Laura Marie Bevilacqua, MD is a clinical cardiac electrophysiology internal medicine in Boston, MA with 32 years of experience. The provider is a field of special interest within the subspecialty of cardiovascular disease, specialty of Internal Medicine, which involves intricate technical procedures to evaluate heart rhythms and determine appropriate treatment for them. Laura Marie Bevilacqua, MD NPI is 1700875507. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF CONNECTICUT SCHOOL OF MEDICINE
Graduation Year:1992

The provider's business location address is:

300 LONGWOOD AVE
BOSTON, MA
ZIP 02115-724
Phone: (617) 355-6793

The NPI 1700875507 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/14/2005 and was last updated on 9/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208000000X	Pediatrics		155889	MASSACHUSETTS	No
2	207RC0001X	Internal Medicine	Clinical Cardiac Electrophysiology	155889	MASSACHUSETTS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	99487301	OTHER	MASSACHUSETTS	NETWORK HEALTH
2	3198235	MEDICAID	MASSACHUSETTS
3	75-00451	OTHER	MASSACHUSETTS	UNITED HEALTHCARE MA
4	8753709	MEDICAID	NEW JERSEY
5	30201468	MEDICAID	NEW HAMPSHIRE
6	J21189	OTHER	MASSACHUSETTS	HMO BLUE
7	003136000	MEDICAID	CONNECTICUT
8	2357326	MEDICAID	NEW YORK
9	LB45398	MEDICAID	RHODE ISLAND
10	J21189	OTHER	MASSACHUSETTS	BCBS MA
11	AA9205	OTHER	MASSACHUSETTS	HARVARD PILGRIM

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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