Organization Active NPI

Childrens Hospital Corporation

Radiology Clinic/Center
Boston, MA

National Provider Identifier

1053635441

Registry record updated Mar 15, 2010

On this page

Key facts
NPPES NPI Registry
Medicare participation
Laboratory certificates & supplier records
National Provider Directory
NPI Registry JSON
Other providers in Boston, MA
Sources for this page

Key facts

NPPES NPI Registry

Primary specialty: Radiology Clinic/CenterTaxonomy code 261QR0200X
Legal business name: CHILDRENS HOSPITAL CORPORATION
Practice address: 300 Longwood Ave
Patient Financial Services Attn Steven Nicoll
Boston, MA 02115-5724
Phone: (857) 218-3391
Fax: (617) 730-0080
NPI assigned: Mar 15, 2010
Organization subpart: No

NPPES NPI Registry

Updated by the provider on Mar 15, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name: Mr. David A Kirshner
Title: Sr VP Finance and Cfo
Phone: (617) 355-6881

Specialties & licenses 1

Specialty (taxonomy)	Code	License	State	Primary
Radiology Clinic/Center	261QR0200X			Primary

Addresses

Primary practice location

300 Longwood Ave
Patient Financial Services Attn Steven Nicoll
Boston, MA 02115-5724

Mailing address

300 Longwood Ave
Patient Financial Services Attn Steven Nicoll
Boston, MA 02115-5724
Phone (857) 218-3391

Other identifiers 11

Identifier	Type	State	Issuer
458829052	Other		CIGNA
6300175	Other		AETNA
110026858B	Medicaid	MA
2222012201	Other	MA	BLUE CROSS INPATIENT
900018	Other	MA	HPHC
0007052	Other	MA	NHP
2222012210	Other	MA	BLUE CROSS OUTPT
2222012230	Other	MA	BLUE CROSS DSUOBS
6561	Other	MA	BMC
643120	Other	MA	TUFTS RADIOLOGIST
110026858A	Medicaid	MA

Other names 1

Childrens Hospital Radiology PFS Doing business as

Medicare participation

Medicare enrollment files

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

Hospital certification: CCN 220122

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name: CHILDRENS HOSP MED CENTER
Certification status: Terminated Other: provider status change, Oct 3, 1986
Provider type (POS): Hospital – Short-term
Participating since: Jul 1, 1966
Last certification: Dec 15, 1983
Beds: 335
Ownership / control type: Other
Facility address: 300 Longwood Ave
Boston, MA 02115

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
22D2289689	Childrens Hospital Pediatric Associates, Inc300 Longwood Ave, Boston, MA 02115	Compliance	Jun 16, 2027

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1268611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268611200000",
    "number": "1053635441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "address_2": "PATIENT FINANCIAL SERVICES ATTN STEVEN NICOLL",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "857-218-3391",
            "fax_number": "617-730-0080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "address_2": "PATIENT FINANCIAL SERVICES ATTN STEVEN NICOLL",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "857-218-3391",
            "fax_number": "617-730-0080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILDRENS HOSPITAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-15",
        "last_updated": "2010-03-15",
        "status": "A",
        "authorized_official_last_name": "KIRSHNER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "SR VP FINANCE AND CFO",
        "authorized_official_telephone_number": "617-355-6881",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "458829052",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "6300175",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110026858B",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS INPATIENT",
            "identifier": "2222012201",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "900018",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHP",
            "identifier": "0007052",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OUTPT",
            "identifier": "2222012210",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS DSUOBS",
            "identifier": "2222012230",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BMC",
            "identifier": "6561",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS RADIOLOGIST",
            "identifier": "643120",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110026858A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Childrens Hospital Radiology PFS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.