CHILDREN'S SPORTS MEDICINE FOUNDATION


Address: 319 Longwood Ave, Boston, MA 02115-5728
Phone: 6173555971

CHILDREN'S SPORTS MEDICINE FOUNDATION (NPI# 1861680720) 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) 1861680720
Entity Type Organization
Organization Name CHILDREN'S SPORTS MEDICINE FOUNDATION
Practice Address 319 Longwood Ave
Boston
MA 02115-5728
Mailing Address Po Box 3694
Boston
MA 02241-3694
Practice Telephone 6173555971
Practice Fax Number 6177300178
Mailing Telephone 5089461665
Mailing Fax Number 5089471293
Enumeration Date 2007-10-04
Last Update Date 2007-10-04
Authorized Official Name LYLE J MICHELI (DIRECTOR)
Authorized Official Telephone 6173555971
Authorized Official Credential M.D.
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 213ES0000X Podiatrist
Specialization: Sports Medicine 		Podiatric Medicine & Surgery Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
MA BCBS M14628 01
MA 9782621 05

Office Location

Street Address 319 LONGWOOD AVE
City BOSTON
State MA
Zip Code 02115-5728

Providers in the same location

NPI Name Taxonomy Address Enumeration
1326040080 Gary P Kearney Urology 319 Longwood Ave, Boston, MA 02115-5728 2005-08-12
1124518329 Brianna Quintiliani Physician Assistant 319 Longwood Ave, Boston, MA 02115 2018-05-14
1831687300 Kevin Walter Wenner Physician Assistant 319 Longwood Ave, Boston, MA 02115-5728 2018-04-30
1740723139 Shannon Savage Physician Assistant 319 Longwood Ave, Boston, MA 02115-5728 2016-12-02
1336591023 Meghan Leigh Keating Physician Assistant 319 Longwood Ave, Floor Six, Boston, MA 02115-5728 2016-07-06
1528418001 Mary Mihovan Nurse Practitioner 319 Longwood Ave, Boston, MA 02115-5728 2016-06-15
1386014173 Jacqueline Hastings Nurse Practitioner 319 Longwood Ave, 6th Floor Sports Medicine, Boston, MA 02115-5728 2015-10-06
1205243078 Agnieszka Kowalczyk Pediatrics 319 Longwood Ave, Boston, MA 02115-5728 2014-07-14
1093121055 Emily Hanson Specialist/Technologist 319 Longwood Ave, Boston, MA 02115-5728 2014-07-10
1053743245 Rachel Stephanie Shade Psychologist 319 Longwood Ave, Boston, MA 02115-5728 2013-07-30
Find all providers in the same location

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 213ES0000X
Grouping Podiatric Medicine & Surgery Service Providers
Classification Podiatrist
Specialization Sports Medicine

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1871629162 Greater Boston Podiatry Associates, PC Podiatrist 427b Washington St, Norwell, MA 02061-2007 2007-02-23
1265546212 David Hugh Greenblott Podiatrist 62 Brown St, Ste 206, Haverhill, MA 01830-6790 2006-08-18
1568439271 Frank J Santopietro Podiatrist 1180 Beacon St, Suite 4d, Brookline, MA 02446-3885 2006-03-01
1881660066 John T Hester Podiatrist 20 Guest St Ste 225, Brighton, MA 02135-2065 2006-02-27
1700852951 Richard W Cullen Podiatrist 300 Chestnut St, Suite500, Needham, MA 02492-2497 2006-02-27
1780658427 John Patrick Mcloughlin Podiatrist 830 Oak St, Suite 222e, Brockton, MA 02301-1168 2006-02-16
1538163373 Charles F Ross Podiatrist 740 Williams St, Pittsfield, MA 01201-7463 2005-06-09

Competitor

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City BOSTON
Zip Code 02115

Improve Information

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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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