Individual provider Active NPI

Amy L Sanderson, M.D.

  • Pediatric Critical Care Medicine Physician
  • Boston, MA
National Provider Identifier
1073656468
Registry record updated Jan 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
220938 Issued in MA
Practice address
300 Longwood Ave
Bader 634
Boston, MA 02115-5724
Phone
(617) 355-7327
NPI assigned
Feb 15, 2007
Last updated
Jan 7, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X 220938 MA Primary

Addresses

Primary practice location

300 Longwood Ave
Bader 634
Boston, MA 02115-5724

Mailing address

300 Longwood Ave
Bader 634
Boston, MA 02115-5724
Phone (617) 355-7327

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: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080108000076 MA Practitioner - Pediatric MedicinePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 0547340218 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Critical Care (Intensivists), Internal Medicine
Education
University of Kansas School of Med (KC/Wich/Sal), 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CHMC Anesthesia Foundation IncGroup PAC ID 0446155568, 131 clinicians

Practice addresses (Care Compare)

300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-6000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
220938MAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Pediatric Associates, Inc Pediatric Critical Care Medicine CurrentSince Jun 1, 2010 Accepting new patients
CHMC Anesthesia Foundation Inc Pediatric Critical Care Medicine CurrentSince Dec 1, 2007 Accepting new patients

Locations

300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956

300 Longwood Ave
#634
Boston, MA 02115
Phone (617) 355-7325

300 Longwood Ave
Ofc
Boston, MA 02115
Phone (617) 355-8083

Interoperability endpoints

  • Direct secure messaging: asanderson22245@direct.bostonchildrens.org

Organizations & group practices 2

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

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357516800000",
    "number": "1073656468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "address_2": "BADER 634",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-7327"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "address_2": "BADER 634",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-7327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERSON",
        "first_name": "AMY",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-15",
        "last_updated": "2013-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "MA",
            "license": "220938",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.