Individual provider Active NPI

Somphit Chinkam, CNM

  • Advanced Practice Midwife
  • Boston, MA
National Provider Identifier
1063498434
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Advanced Practice MidwifeTaxonomy code 367A00000X
License
RN200952 Issued in MA
Practice address
850 Harrison Ave
5TH FL
Boston, MA 02118
Phone
(617) 414-2000
Fax
(617) 414-5798
NPI assigned
Dec 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X RN200952 MA Primary

Addresses

Primary practice location

850 Harrison Ave
5TH FL
Boston, MA 02118

Mailing address

960 Mass Ave
FL 2
Boston, MA 02118

Other identifiers 1

IdentifierTypeStateIssuer
110015825AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100108000652 MA Practitioner - Certified Nurse Midwife (CNM) 2567503873 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Boston University Obstetrics and Gynecology Foundation, Inc. CurrentSince Nov 8, 2009 Accepting new patients
Boston Medical Center Corporation Current Accepting new patients
Roxbury Comprehensive Community Health Center Past Accepting new patients
Roxbury Comprehensive Community Health Center, Inc. PastSince Aug 21, 1997 Accepting new patients

Locations

850 Harrison Ave
Fl 5
Boston, MA 02118
Phone (617) 414-2000

850 Harrison Ave
Fl 4
Boston, MA 02118
Phone (617) 414-2000

720 Harrison Ave
Boston, MA 02118
Phone (617) 638-7460

960 Massachusetts Ave
Ste 2
Boston, MA 02118

720 Harrison Ave
Ste 1105
Boston, MA 02118
Phone (617) 414-2000

720 Harrison Ave
#503
Roxbury, MA 02118
Phone 6174145404 ext. 2

Interoperability endpoints

  • Direct secure messaging: schinkam9793@direct.bmc.masshiway.net

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1134950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683504000000",
    "number": "1063498434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASS AVE",
            "address_2": "FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 HARRISON AVE",
            "address_2": "5TH FL",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-414-2000",
            "fax_number": "617-414-5798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHINKAM",
        "first_name": "SOMPHIT",
        "credential": "CNM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-19",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "MA",
            "license": "RN200952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110015825A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.