Active NPI
John Anthony Enis, M.D.
- Diagnostic Radiology Physician
- West Roxbury, MA
National Provider Identifier
1023215316
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 26786
- Practice address
- 1400 VFW Pkwy
West Roxbury, MA 02132-4927 - Phone
- (857) 203-6448
- NPI assigned
- Jun 29, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neuroradiology Physician | 2085N0700X | 26786 | OK | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Diagnostic Radiology Physician | 2085R0202X | 26786 | OK | Primary |
Addresses
Primary practice location
1400 VFW Pkwy
West Roxbury, MA 02132-4927
Mailing address
300 2ND Ave
Unit 4149
Needham, MA 02494
Phone (210) 286-4681
Other practice location 1
2200 Bergquist Dr Ste 1
59 MDW/59 Mdog/59 RSQ/SG06
Lackland A F B, TX 78236-9908
Phone (210) 286-4681
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26786 | OK | MD | Neuroradiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1183075200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1023215316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 2ND AVE",
"address_2": "UNIT 4149",
"city": "NEEDHAM",
"state": "MA",
"postal_code": "02494",
"telephone_number": "210-286-4681"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 VFW PKWY",
"city": "WEST ROXBURY",
"state": "MA",
"postal_code": "021324927",
"telephone_number": "857-203-6448"
}
],
"practiceLocations": [
{
"address_1": "2200 Bergquist Dr Ste 1",
"address_2": "59 MDW/59 MDOG/59 RSQ/SG06",
"address_purpose": "LOCATION",
"city": "Lackland A F B",
"state": "TX",
"postal_code": "782369908",
"country_code": "US",
"telephone_number": "210-286-4681",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ENIS",
"first_name": "JOHN",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-29",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "2085N0700X",
"taxonomy_group": "",
"desc": "Radiology, Neuroradiology",
"state": "OK",
"license": "26786",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "OK",
"license": "26786",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Roxbury, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.