CHMC SURGICAL GYNECOLOGY GROUP (NPI# 1295360824) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295360824 |
| Entity Type | Organization |
| Organization Name | CHMC SURGICAL GYNECOLOGY GROUP |
| Practice Address |
300 Longwood Ave Boston MA 02115-5724 |
| Practice Telephone | 6173556000 |
| Mailing Telephone | 6173556000 |
| Enumeration Date | 2020-03-04 |
| Last Update Date | 2020-03-04 |
| Authorized Official Name | STEVEN FISHMAN (CHIEF, DEPARTMENT OF SURGERY) |
| Authorized Official Telephone | 6173553040 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| Street Address |
300 LONGWOOD AVE |
| City | BOSTON |
| State | MA |
| Zip Code | 02115-5724 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588667539 | Barry Grant Zallen | Pediatrics | 300 Longwood Ave, Children's Hospital, Au 105, Boston, MA 02115-5724 | 2005-05-23 |
| 1730780669 | Hannah Fraser | Registered Nurse | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-11-06 |
| 1164023776 | Hannah Brewer | Social Worker | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-11-02 |
| 1104423680 | Justin Matthias Hintze | Otolaryngology | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-10-07 |
| 1295340388 | Kathryn Theresa Moffa | Psychologist | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-15 |
| 1144835224 | Abby Elizabeth Bandi | Social Worker | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-15 |
| 1558976845 | Hilary Segar Garber | Nurse Practitioner | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-13 |
| 1063026003 | Lauren M Dilullo | Psychologist | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-08 |
| 1013521004 | Carl Britto | Student in an Organized Health Care Education/Training Program | 300 Longwood Ave, Boston, MA 02115-5737 | 2020-09-07 |
| 1760096887 | Rebecca Marie Leslie | Nurse Practitioner | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-04 |
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| 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 Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164909925 | Estefania D. Rivera Mudafort | Obstetrics & Gynecology | 850 Harrison Ave Fl 5, Boston, MA 02118-4001 | 2018-07-25 |
| 1376035881 | Erika R Wallace | Obstetrics & Gynecology | 800 Washington Street #22, Obgyn Residency Office, Boston, MA 02111 | 2018-05-31 |
| 1649760851 | Andrea Jaresova | Obstetrics & Gynecology | 330 Brookline Ave # Shapiro8, Boston, MA 02215-5491 | 2018-05-14 |
| 1063920767 | Jean Wilner Noel | Obstetrics & Gynecology | 11 Nevins St Ste 302, Boston, MA 02135-3514 | 2018-01-16 |
| 1740705243 | Ronan Paul Sugrue | Obstetrics & Gynecology | 75 Francis Street Brigham and Womens' Hospital, Department of Obstetrics and Gynecology, Boston, MA 02115 | 2017-08-07 |
| 1386173144 | Matthew Shear | Obstetrics & Gynecology | 330 Brookline Ave # 3, Boston, MA 02215-5400 | 2017-06-06 |
| 1336678390 | Lindsey Robyn Cypen | Obstetrics & Gynecology | 330 Brookline Avenue East Campus, Kirstein 3, Boston, MA 02215 | 2017-06-05 |
| 1629431614 | Victoria Chia | Obstetrics & Gynecology | 85 E Concord St Fl 6, Boston, MA 02118-2335 | 2016-03-29 |
| 1801277736 | Karissa Hammer | Obstetrics & Gynecology | 55 Fruit St Ste 10a, Boston, MA 02114-2696 | 2015-06-16 |
| 1831584895 | Chenchen Huang Sun | Obstetrics & Gynecology | 800 Washigton St., 800 Washington St, Boston, MA 02111 | 2015-04-06 |
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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.