JONATHAN VANDALE


Address: 60 Fenwood Rd Fl 2, Boston, MA 02115-6128
Phone: 6177325322

JONATHAN VANDALE (NPI# 1154805281) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1154805281
Entity Type Individual
Full Name JONATHAN VANDALE
Credential PA-C
Practice Address 60 Fenwood Rd Fl 2
Boston
MA 02115-6128
Mailing Address 831 E 2nd St # 2
South Boston
MA 02127-2333
Practice Telephone 6177325322
Mailing Telephone 4132629376
Enumeration Date 2018-09-25
Last Update Date 2018-09-25
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207XX0005X Orthopaedic Surgery
Specialization: Sports Medicine
PA6762 MA Allopathic & Osteopathic Physicians

Office Location

Street Address 60 FENWOOD RD FL 2
City BOSTON
State MA
Zip Code 02115-6128

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1013524339 Jacqueline Busa Student in an Organized Health Care Education/Training Program Northeastern University 336 Huntington Ave, Boston, MA 02115 2020-09-30
1417564279 Katherine Rose Brainard Student in an Organized Health Care Education/Training Program 336 Huntington Avenue, Boston, MA 02115 2020-09-25
1679189112 Tara Baxter Orthopaedic Surgery Boston Children's Hospital - Sports Medicine Division, 319 Longwood Avenue, Boston, MA 02115 2020-09-21
1053923110 Wendy Tu Student in an Organized Health Care Education/Training Program 75 Francis Street Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115 2020-08-20
1477177335 Nicolas Wyvekens Student in an Organized Health Care Education/Training Program 75 Francis Street Department of Pathology, Brigham And, Boston, MA 02115 2020-06-05
1669095923 Erin Crocker Student in an Organized Health Care Education/Training Program Northeastern University Physician Assistant Program, 360 Huntington Avenue, Boston, MA 02115 2020-05-21
1033732417 Tyler Francis Hayes Student in an Organized Health Care Education/Training Program Gordon Hall, Suite 213, 25 Shattuck Street, Boston, MA 02115 2020-05-20
1982225090 Emily Blake Student in an Organized Health Care Education/Training Program 202 Robinson Hall, 360 Huntington Avenue, Boston, MA 02115 2020-04-29
1891315495 Stephanie Schoch Student in an Organized Health Care Education/Training Program 360 Huntington Ave., 202 Robinson Hall, Boston, MA 02115 2020-04-23
1427678093 Meghan Miles Student in an Organized Health Care Education/Training Program 360 Huntington Avenue 202 Robinson Hall, Boston, MA 02115 2020-04-23
Find all providers in zip 02115

Taxonomy Information

Taxonomy Code 207XX0005X
Grouping Allopathic & Osteopathic Physicians
Classification Orthopaedic Surgery
Specialization Sports Medicine

Taxonomy Definition

An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton changed, source changed] Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. ACGME Accredited Program Requirements: 1 year GME in the specialty + 5 years of Orthopaedic Surgery for a total of 6 years

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1679189112 Tara Baxter Orthopaedic Surgery Boston Children's Hospital - Sports Medicine Division, 319 Longwood Avenue, Boston, MA 02115 2020-09-21
1851710487 Evan Alexander O'donnell Orthopaedic Surgery 55 Fruit Street, Yaw3-3561, Boston, MA 02114 2014-04-10
1588869168 Matthew J Salzler Orthopaedic Surgery 800 Washington St # 306, Boston, MA 02111-1552 2007-06-15
1144608381 Aditi Majumdar Orthopaedic Surgery 300 Longwood Ave, Boston, MA 02115-5724 2015-05-08
1326200858 Melissa A Christino Orthopaedic Surgery 300 Longwood Ave, Boston, MA 02115 2008-06-26
1619141496 Thomas Hartmann Wuerz Orthopaedic Surgery 125 Parker Hill Ave, Boston, MA 02120-2847 2008-04-14
1184808131 Matthew David Milewski Orthopaedic Surgery 300 Longwood Ave, Boston, MA 02115-5724 2007-12-27
1598864449 Richard Michael Wilk Orthopaedic Surgery 75 Francis St, Boston, MA 02115-6110 2006-09-21
1235243130 Arun J Ramappa Orthopaedic Surgery 330 Brookline Ave, Shapiro 2, Boston, MA 02215-5400 2006-08-18
1740216811 Children's Sports Medicine Foundation Inc. Orthopaedic Surgery 319 Longwood Ave, Boston, MA 02115-5728 2006-06-23
Find all providers in BOSTON

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City BOSTON
Zip Code 02115

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Dataset Information

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.

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