PEYMAAN SAM BANANKHAH (NPI# 1134688120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134688120 |
| Entity Type | Individual |
| Full Name | PEYMAAN SAM BANANKHAH |
| Practice Address |
300 Mount Auburn St Cambridge MA 02138-5600 |
| Mailing Address |
2474 John F Kennedy Blvd Jersey City NJ 07304-1966 |
| Practice Telephone | 6174923500 |
| Enumeration Date | 2019-03-18 |
| Last Update Date | 2019-07-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 281163 | MA | Allopathic & Osteopathic Physicians |
| Street Address |
300 MOUNT AUBURN ST |
| City | CAMBRIDGE |
| State | MA |
| Zip Code | 02138-5600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568466316 | Frederick W Ruymann | Internal Medicine | 300 Mount Auburn St, Ste 405, Cambridge, MA 02138-5665 | 2005-06-09 |
| 1508389636 | Emily Holmes | Nurse Practitioner | 300 Mount Auburn St, Cambridge, MA 02138-5600 | 2017-07-20 |
| 1396277455 | Dr. Susan Pories | Surgery | 300 Mount Auburn St, Suite 509, Cambridge, MA 02138-5600 | 2017-03-29 |
| 1992243554 | Allison Vandermeulen | Specialist/Technologist, Other | 300 Mount Auburn St, Suite 505, Cambridge, MA 02138-5600 | 2017-02-03 |
| 1982142519 | Jessica Jeanne Sullivan | Registered Nurse | 300 Mount Auburn St, Cambridge, MA 02138-5600 | 2017-02-02 |
| 1578017497 | Andrew Dallahan Donnelly | Registered Nurse | 300 Mount Auburn St, Suite 517, Cambridge, MA 02138-5600 | 2016-08-09 |
| 1447634670 | Troy Tweiten | Internal Medicine | 300 Mount Auburn St, Cambridge, MA 02138-5600 | 2015-07-17 |
| 1235528696 | Laura Boldyrev | Nurse Practitioner | 300 Mount Auburn St, Suite 509, Cambridge, MA 02138-5600 | 2015-01-22 |
| 1649673724 | Cambridge Digestive Health PC | Internal Medicine | 300 Mount Auburn St, Suite 405, Cambridge, MA 02138-5600 | 2014-10-02 |
| 1609206739 | Cynthia Waite | Nurse Practitioner | 300 Mount Auburn St, Physician Associates At Mount Auburn Hospital Suite 410, Cambridge, MA 02138-5600 | 2013-11-27 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922618610 | Khushboo Vijay Bhatia | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency Program, Mount Auburn Hospi, 330 Mt. Auburn Street, Cambridge, MA 02138 | 2020-08-06 |
| 1780204156 | Ashna Grover | Student in an Organized Health Care Education/Training Program | 330 Mt Auburn Street Mount Auburn Hospital, Internal Medicine Residency Program, Cambridge, MA 02138 | 2020-04-25 |
| 1790330298 | Cambridge Periodontics LLC | Dentist | 1692 Massachusetts Ave Ste 3, Cambridge, MA 02138 | 2019-08-02 |
| 1295389765 | Yulia Levit | Technician/Technologist | 1208 Massachussets Av, Cambridge, MA 02138 | 2019-08-01 |
| 1720645393 | Chinmay Tusharkumar Jani | Student in an Organized Health Care Education/Training Program | Mount Auburn Hospital, 330 Mt Auburn Street, Cambridge, MA 02138 | 2019-05-20 |
| 1386209831 | Alexander Ryan Walker | Internal Medicine | 300 Mount Auburn Street Mount Auburn Hospital, Dept. of Medicine, Cambridge, MA 02138 | 2019-05-09 |
| 1659844868 | Aimee Hsieh | Social Worker | 525 Mount Auburn Street, Cambridge, MA 02138 | 2019-01-10 |
| 1043733389 | Armida Fruzzetti | Psychologist | 900 Concord Avenue, Cambridge, MA 02138 | 2017-07-19 |
| 1174984827 | Jenna Mezin Schmid | Psychologist | 75 Mt Auburn St 4 East, Harvard University Health Services, Cambridge, MA 02138 | 2016-03-09 |
| 1316313208 | Kelly Abbott | Optometrist | 12 Eliot St., Cambridge, MA 02138 | 2015-08-14 |
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| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| 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. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386209831 | Alexander Ryan Walker | Internal Medicine | 300 Mount Auburn Street Mount Auburn Hospital, Dept. of Medicine, Cambridge, MA 02138 | 2019-05-09 |
| 1578952255 | Christian Mewaldt | Internal Medicine | 90 Hancock St Apt 3, Cambridge, MA 02139 | 2015-01-17 |
| 1922413582 | Stephanie Johanna Mascia | Internal Medicine | 625 Mount Auburn St Ste 104, Cambridge, MA 02138-4518 | 2014-06-23 |
| 1770920217 | Judy Yee Kwok | Internal Medicine | 163 Gore Street, Cambridge, MA 02149-2420 | 2013-05-23 |
| 1063857969 | Jia Liu | Internal Medicine | 24 Lilac Ct, Cambridge, MA 02141-1912 | 2013-05-06 |
| 1891923199 | Nelson Kisob Aweh | Internal Medicine | 255 Garden St, Apt # 7, Cambridge, MA 02138-1256 | 2009-06-24 |
| 1326275017 | Anthony Andrew Philippakis | Internal Medicine | 53 Ellery St # 2, Cambridge, MA 02138-4230 | 2009-06-19 |
| 1386871317 | Elaine Hsieh | Internal Medicine | 141 Larch Road, Cambridge, MA 02138-0213 | 2009-06-17 |
| 1134372618 | Lisa Lynn Vonmoltke | Internal Medicine | 35 Landsdowne St, Cambridge, MA 02139-4232 | 2008-10-29 |
| 1447427117 | Andrew Marc Schutzbank | Internal Medicine | 240 Norfolk St, Cambridge, MA 02139-1423 | 2008-05-13 |
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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.