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LESTAT ALI MD
NPI 1639828395
Internal Medicine in Boston, MA

Active since March 21, 2022PECOS Enrolled
1 JIMMY FUND WAY # SM-558A, BOSTON, MA 02115(617) 632-3000 Get Directions Write a Review

NPPES record last updated: June 27, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jun 27, 2025, Jul 15, 2024, Jul 12, 2024 (3 updates tracked since 2024).

About Lestat Ali Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

LESTAT ALI MD (NPI 1639828395) is an individual internal medicine provider in Boston, Massachusetts, licensed in Massachusetts (1020544) and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS and maintains a secondary practice location in Boston.

NPPES Registry Identity

NPI1639828395
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameLESTAT ALICredential: MD
Location Address1 JIMMY FUND WAY # SM-558ABoston, MA 02115-6007
Mailing Address1 Jimmy Fund Way # Sm-558aBoston, MA 02115-6007 · (617) 632-3000
Phone(617) 632-3000
Sole ProprietorNo
Enumeration DateMarch 21, 2022
Last NPPES UpdateJune 27, 20253 updates tracked since enumeration
NPPES CertifiedJune 27, 2025
✔ NPI 1639828395 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in MA · 1020544
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
1 JIMMY FUND WAY # SM-558A, Boston, MA 02115
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Secondary Practice Location 1

Location 155 Fruit StBoston, MA 02114-2696 · Phone (617) 726-5820

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lestat Ali Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02115 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$144.11 typical visit price
range $63.72 – $189.86
Typical copayment $36.02 (range $15.93 – $47.46)
Most-billed visit code 99204
Established Patient
$111.18 typical visit price
range $21.07 – $155.29
Typical copayment $27.79 (range $5.26 – $38.82)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lestat Ali's NPI number?

The NPI number for Lestat Ali is 1639828395. It was assigned to this individual provider in the NPPES registry on March 21, 2022.

Where is Lestat Ali located?

Lestat Ali practices at 1 Jimmy Fund Way # Sm-558a, Boston, MA 02115. The listed phone number is (617) 632-3000.

What is Lestat Ali's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Lestat Ali enrolled in Medicare?

Yes. Lestat Ali is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Lestat Ali was last updated on June 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.