KIMBERLEY SHUI-YAN MAK (NPI# 1891015350) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891015350 |
| Entity Type | Individual |
| Full Name | KIMBERLEY SHUI-YAN MAK |
| Credential | M.D., M.P.H. |
| Practice Address |
830 Harrison Ave Moakley Ll100 Boston MA 02118-2905 |
| Mailing Address |
720 Harrison Ave Dob 503 Boston MA 02118-2371 |
| Practice Telephone | 6176387070 |
| Practice Fax Number | 6176387037 |
| Enumeration Date | 2010-06-08 |
| Last Update Date | 2016-06-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
253487 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 110103293A | 05 |
| Street Address |
830 HARRISON AVE MOAKLEY LL100 |
| City | BOSTON |
| State | MA |
| Zip Code | 02118-2905 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316937436 | Minh Tam Truong | Radiology | 830 Harrison Ave, Moakley Building Ll100, Boston, MA 02118 | 2005-10-28 |
| 1457950131 | Maggie Ruderman | Genetic Counselor, MS | 830 Harrison Ave, Boston, MA 02118-2905 | 2020-10-22 |
| 1760096606 | Fabio Petrocca | Student in an Organized Health Care Education/Training Program | 830 Harrison Ave, Boston, MA 02118-2905 | 2020-09-08 |
| 1801447495 | Kailey Vitale | Speech-Language Pathologist | 830 Harrison Ave, Boston, MA 02118-2905 | 2019-09-25 |
| 1437718228 | Kayla Mcdonald | Physician Assistant | 830 Harrison Ave, Moakley, Suite 3400, Boston, MA 02118 | 2019-06-06 |
| 1154984888 | Elizabeth Tiani | Nurse Practitioner | 830 Harrison Ave, Boston, MA 02118 | 2019-04-18 |
| 1669938981 | Lynsie Rae Adams | Nurse Practitioner | 830 Harrison Ave, Moakley, 3rd Floor, Boston, MA 02118 | 2019-02-11 |
| 1548754385 | Lisa Jiyoung Kim | Nurse Practitioner | 830 Harrison Ave, Moakley, 3rd Floor, Boston, MA 02118 | 2018-06-15 |
| 1891226650 | Navid Alavi | Internal Medicine | 830 Harrison Ave, Moakley, 3rd Floor, Boston, MA 02118 | 2017-03-23 |
| 1952842189 | Samuel Rubin | Otolaryngology | 830 Harrison Ave, 1st Floor, Boston, MA 02118-2905 | 2017-03-20 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 02118 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528488269 | Erik Steven Anderson | Radiology | 330 Brookline Ave # Fnb-25, Boston, MA 02215-5491 | 2014-04-21 |
| 1295994978 | Jonathan Daniel Schoenfeld | Radiology | 450 Brookline Ave # Dal2-57, Department of Radiation Oncology, Boston, MA 02215-5418 | 2008-06-06 |
| 1922211655 | Kathryn E. Huber | Radiology | 800 Washington St # 359, Tufts Medical Center, Department of Radiation Oncology, Boston, MA 02111-1552 | 2007-05-08 |
| 1972674588 | Rinaa S Punglia | Radiology | 44 Binney St Dana Farber Cancer Institute, Ctr for Outcomes and Polic Research, Boston, MA 02115 | 2006-11-13 |
| 1467487900 | Elizabeth H Baldini | Radiology | 75 Francis Street Asb1l2, Brigham and Women's Hospital Radiation Oncology, Boston, MA 02115 | 2006-07-12 |
| 1790719458 | Irving David Kaplan | Radiology | Bidmc-radiation Therapy, 330 Brookline Avenue, Boston, MA 02215 | 2006-07-10 |
| 1306874169 | Annie Waifong Chan | Radiology | 100 Blossoms Street, Cox Ll Massachusetts General Hospital, Boston, MA 02114 | 2006-06-29 |
| 1902842966 | Yen-lin E Chen | Radiology | 100 Blossom Street Cox Ll, Boston, MA 02114 | 2006-06-20 |
| 1245277441 | Seth A Kaufman | Radiology | 750 Washington Street, Box 359, New England Medical Center, Boston, MA 02111 | 2006-05-31 |
| 1104877646 | Jay Harris | Radiology | 44 Binney Street Dana 1622, Dana Farber Cancer Institute Department of Radiation On, Boston, MA 02115 | 2006-05-12 |
| Find all providers in BOSTON | ||||
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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.