Individual ProviderTheodora PappaInternal MedicineAllopathic & Osteopathic PhysiciansPractice Address221 Longwood Ave, Boston, MA 02115-5817(617) 732-5666PECOS EnrollmentBased on the most recent information from CMS, provider Theodora Pappa is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1285154674Provider TypeIndividualFull NamePappa, TheodoraTitleDr.CredentialMD, PHDGenderFemaleSole ProprietorNoEnumeration Date6/27/2017Last Updated7/6/2021Contact InformationPractice LocationPractice Address221 Longwood Ave, Boston, MA 02115-5817Phone(617) 732-5666FaxUnlisted FaxMailing LocationMailing Address221 Longwood Ave, Boston, MA 02115-5817Phone(617) 732-5666FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207R00000XPrimaryDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense278465MassachusettsCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense125.071464IllinoisCode207RE0101XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense279830Massachusetts