DR. AMITABH GAUTAM MD NPI 1750389565

NPI Information

NPI: 1750389565
Provider Name: DR. AMITABH GAUTAM, MD
Classification: Transplant Surgery - 204F00000X
Entity Type: Individual
Organization: SKILLED FACILITY HEALTH CARE SOLUTIONS INC

PECOS Registration: Yes

Address:
725 ALBANY ST
SHAPIRO 7TH FLOOR, SUITE 7A
BOSTON, MA
ZIP 02118
Phone: (617) 638-8430
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DR. Amitabh Gautam, MD is a transplant surgery in Boston, MA with 44 years of experience. The provider is definition to come. DR. Amitabh Gautam, MD NPI is 1750389565. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

725 ALBANY ST
SHAPIRO 7TH FLOOR, SUITE 7A
BOSTON, MA
ZIP 02118-526
Phone: (617) 638-8430
Fax: (617) 638-8427

The NPI 1750389565 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 7/14/2005 and was last updated on 6/13/2014.

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	208600000X	Surgery		233660	MASSACHUSETTS	No
2	204F00000X	Transplant Surgery		233660	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	7009550	MEDICARE ID-TYPE UNSPECIFIED	RHODE ISLAND	RIH TRANSPLANT
2	000345501	MEDICARE PIN	MASSACHUSETTS
3	110003575A	MEDICAID	MASSACHUSETTS
4	9023429	MEDICAID	RHODE ISLAND

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: 11/14/2023

NPI Synchronization or Removal

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