CHANGHEE PARK (NPI# 1013570605) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1013570605 |
| Entity Type | Individual |
| Full Name | CHANGHEE PARK |
| Credential | NP |
| Practice Address |
30 Winter St Boston MA 02108-4720 |
| Practice Telephone | 6174260600 |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2019-04-18 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
2307013 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
30 WINTER ST |
| City | BOSTON |
| State | MA |
| Zip Code | 02108-4720 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588626501 | Peggy Lyn Johnson | Psychiatry & Neurology | 30 Winter St, Suite 802, Boston, MA 02108-4720 | 2006-04-05 |
| 1417554858 | Robin Alsarras | Registered Nurse | 30 Winter St, Boston, MA 02108-4720 | 2020-10-08 |
| 1780231779 | Andrew Mendonsa | Registered Nurse | 30 Winter St, Boston, MA 02108-4720 | 2019-08-23 |
| 1427605997 | Sergio Serpa | Registered Nurse | 30 Winter St, Boston, MA 02108-4720 | 2019-08-20 |
| 1164801486 | Artemis Diane Panagopoulos | Physician Assistant | 30 Winter St, 12th Floor, Boston, MA 02108-4720 | 2015-05-19 |
| 1851797542 | Commonwealth Care Alliance, Inc. | Exclusive Provider Organization | 30 Winter St, Boston, MA 02108-4720 | 2014-11-07 |
| 1245640853 | Zelys Yiseirie Adorno | Pharmacist | 30 Winter St, Boston, MA 02108-4720 | 2014-05-05 |
| 1205252731 | Brynn O'donnell | Registered Nurse | 30 Winter St, Boston, MA 02108 | 2014-03-07 |
| 1740579499 | Amparo Velasquez | Counselor | 30 Winter St, Boston, MA 02108-4720 | 2011-04-04 |
| 1447562335 | Lady-thelma W Bolduc | Registered Nurse | 30 Winter St, Boston, MA 02108-4720 | 2010-07-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366947954 | Karrin Weisenthal | Emergency Medicine | 1 Boston Pl Rm 1322, Boston, MA 02108 | 2018-03-27 |
| 1619225786 | Ahmed M Hamada-ibrahim | Dentist | 32 Tremont Sytreet, Citidental, Boston, MA 02108 | 2012-08-21 |
| 1114226750 | Richard J Osorio | Counselor | 30 Winter Street, Boston Asap, Boston, MA 02108 | 2011-03-22 |
| 1487956835 | Melissa Jean Leite | Dental Hygienist | 250 Washington Street, Boston, MA 02108 | 2010-11-17 |
| 1518274117 | Ada Stefanescu | Internal Medicine | Mgh Downtown Associates, 294 Washington St Ste 210, Boston, MA 02108 | 2010-09-03 |
| 1679798599 | Lauren Carter Ledbetter | Social Worker | Ten Milk Street, Boston, MA 02108 | 2007-04-16 |
| 1790900157 | Lawrence K Gottlieb | Internal Medicine | Intermed Advisors Inc., One Boston Place, Suite 2815, Boston, MA 02108 | 2007-04-13 |
| 1285761841 | Gerardo A Yanayaco | Internal Medicine | Laser Hair Removal, LLC, 333 Washington Street, #221, Boston, MA 02108 | 2007-02-28 |
| 1295863603 | William F Sullivan | Counselor | Adcare, 14 Beacon Street, 801, Boston, MA 02108 | 2007-02-28 |
| 1659432573 | Madeleine I Littman | Psychologist | 15 Court Square, Suite 830, Boston, MA 02108 | 2006-12-13 |
| Find all providers in zip 02108 | ||||
| Taxonomy Code | 363LP2300X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578116133 | Riva Stephens | Nurse Practitioner | 281 Beacon St Apt 12, Boston, MA 02116-1273 | 2019-07-22 |
| 1548736077 | Shashi Narayan Uhlmann | Nurse Practitioner | 360 Huntington Ave Bldg 135, Boston, MA 02115-5000 | 2018-10-23 |
| 1669973244 | Teresa Morreale | Nurse Practitioner | 243 Charles St 712, Boston, MA 02114 | 2018-02-28 |
| 1790159697 | Malgorzata E Smas | Nurse Practitioner | 16 Anderson St Apt 2, Boston, MA 02114-3645 | 2015-11-16 |
| 1881083152 | Phuong My Ho | Nurse Practitioner | 72 E Concord St # 2, Boston, MA 02118-2307 | 2015-01-09 |
| 1285837336 | Rebecca Koeniger Donohue | Nurse Practitioner | 94 Pilgrim Rd, Boston, MA 02215-4127 | 2007-06-07 |
| 1184238438 | Michele Newman | Nurse Practitioner | 55 Fruit St, Boston, MA 02114-2621 | 2020-09-03 |
| 1023628468 | Bryar Hasenjaeger | Nurse Practitioner | 330 Brookline Ave, Boston, MA 02215-5400 | 2020-07-31 |
| 1659925907 | Jacqueline Suzanne Roman | Nurse Practitioner | 55 Fruit St, Boston, MA 02114-2696 | 2019-07-25 |
| 1912563180 | Julian Allroth Dormitzer | Nurse Practitioner | 1340 Boylston St, Boston, MA 02215-4302 | 2019-05-14 |
| Find all providers in BOSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.