DR. ANSU MAMMEN NORONHA (NPI# 1568557775) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568557775 |
| Entity Type | Individual |
| Full Name | DR. ANSU MAMMEN NORONHA |
| Other Name | ANSU A MAMMEN |
| Credential | M.D. |
| Practice Address |
830 Harrison Avenue Moakley, 2nd Floor Boston MA 02118-2905 |
| Mailing Address |
720 Harrison Ave # Dob503 Boston MA 02118-2371 |
| Practice Telephone | 6176386525 |
| Practice Fax Number | 6176387448 |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2019-07-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 226565 | MA | Allopathic & Osteopathic Physicians |
| Y | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
226565 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 110083854A | 05 |
| Street Address |
830 HARRISON AVENUE MOAKLEY, 2ND FLOOR |
| City | BOSTON |
| State | MA |
| Zip Code | 02118-2905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316929342 | Jennifer F Tseng | Surgery | 830 Harrison Avenue, Moakley, Suite 3400, Boston, MA 02118 | 2005-11-16 |
| 1629569702 | Kelsey Jean Burke | Physician Assistant | 830 Harrison Avenue, Moakley, Suite 3400, Boston, MA 02118 | 2018-05-23 |
| 1881131019 | Nora Carr | Nurse Practitioner | 830 Harrison Avenue, Moakley, Suite 1200, Boston, MA 02118 | 2017-01-25 |
| 1336697382 | Samuel Robert Lajoie | Physician Assistant | 830 Harrison Avenue, Moakley, Suite 3500, Boston, MA 02118 | 2016-09-20 |
| 1790148864 | Charlene Julien | Nurse Practitioner | 830 Harrison Avenue, Moakley, 2nd Floor, Boston, MA 02118-2335 | 2016-04-05 |
| 1740640739 | Nicholas Peter Simms | Physician Assistant | 830 Harrison Avenue, Suite 1400, Boston, MA 02118-2784 | 2016-03-03 |
| 1699150938 | Brandy Nichole Kenner Keefe | Nurse Practitioner | 830 Harrison Avenue, Suite 1400, Boston, MA 02118 | 2015-07-28 |
| 1508278169 | Hossein Sadrzadeh | Internal Medicine | 830 Harrison Avenue, Moakley, 3rd Floor, Boston, MA 02118 | 2014-05-29 |
| 1952729717 | Eric I Marks | Internal Medicine | 830 Harrison Avenue, Moakley, 3rd Floor, Boston, MA 02118 | 2014-03-30 |
| 1780018077 | Kimberly Ann Nehiley | Nurse Practitioner | 830 Harrison Avenue, Moakley, 3rd Floor, Boston, MA 02118 | 2013-08-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649870023 | Carlos E Salazar | Counselor | Hcrc 23 Bradston St., Boston, MA 02118 | 2020-10-27 |
| 1780292607 | Jinal Gandhi | Student in an Organized Health Care Education/Training Program | Shapiro Primary Care, 725 Albany Street, Boston, MA 02118 | 2020-07-16 |
| 1669094777 | German Eduardo Velez | Student in an Organized Health Care Education/Training Program | One Boston Medical Center Place Boston Medical Center, Boston, MA 02118 | 2020-05-12 |
| 1255969895 | Isabela Medeiros Heringer Pereira | Student in an Organized Health Care Education/Training Program | 670 Albany Stree, 4th Floor, Boston, MA 02118 | 2020-03-30 |
| 1033746466 | Karan Sunil Hingorani | Student in an Organized Health Care Education/Training Program | Shapiro Primary Care, 725 Albany Street, Precepting Room, Boston, MA 02118 | 2020-03-25 |
| 1326672791 | Azza Ahmed | Dentist | 635 Albany St. G-744, Boston, MA 02118 | 2020-02-25 |
| 1538707401 | Jane Margolis | Social Worker | 840 Harrison Ave., Dowling 2 South, Boston, MA 02118 | 2019-12-11 |
| 1871134833 | Supontep Teerakanok | Dentist | Henry Goldman School of Dental Medicine, 635 Albany St, Boston, MA 02118 | 2019-10-01 |
| 1750939583 | Qasim Silman Ajmi | Orthopaedic Surgery | Department of Orthopaedic Surgery Boston Medical Center, 850 Harrison Ave Dowling 2 North, Boston, MA 02118 | 2019-08-26 |
| 1922655539 | Jami Ryan Pollard | Physician Assistant | 840 Harrison Avenue, Menino Building, Boston, MA 02118 | 2019-08-20 |
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| Taxonomy Code | 207RG0100X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Gastroenterology |
| An internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal 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 |
|---|---|---|---|---|
| 1194366849 | Halpert Medical LLC | Internal Medicine | 27 Pier 7, Boston, MA 02129-4226 | 2019-10-03 |
| 1861913881 | Aymeric Becq | Internal Medicine | 330 Brookline Avenue, Dana 603, Boston, MA 02215 | 2017-06-29 |
| 1386019503 | Boston Food Allergy Center LLC | Internal Medicine | 65 Harrison Ave Ste 201, Boston, MA 02111-1924 | 2015-12-14 |
| 1477996650 | William Thomas Clarke | Internal Medicine | 330 Brookline Ave # Rabb400, Boston, MA 02215-5400 | 2013-04-08 |
| 1487908141 | Jose Manuel Mella | Internal Medicine | 330 Brookline Ave Da 501, East Campus, Beth Israel Deaconess Medical Center, Boston, MA 02215-5403 | 2012-11-02 |
| 1003169327 | Rong J Guan, Md LLC | Internal Medicine | 30 Kneeland St Fl 5, Boston, MA 02111-1528 | 2012-10-24 |
| 1043479587 | Vilas R Patwardhan | Internal Medicine | 110 Francis St, Suite 8e, Beth Israel Deaconess Medical Center, Boston, MA 02215 | 2008-06-09 |
| 1639378789 | Alan Colm Moss | Internal Medicine | 725 Albany St Ste 6b, Boston, MA 02118-3549 | 2007-07-17 |
| 1508080060 | Daisy De-peralta-daly | Internal Medicine | 389 Commonwealth Ave, Boston, MA 02115-1802 | 2007-04-13 |
| 1043306558 | Harry T Anastopoulos | Internal Medicine | 110 Francis St Suite 8e, Boston, MA 02215 | 2006-10-04 |
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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.