Individual provider Active NPI

Nathan C Cardoos, M.D.

  • Sports Medicine (Family Medicine) Physician
  • Boston, MA
National Provider Identifier
1083908685
Registry record updated Jul 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
258669 Issued in MA
Practice address
915 Commonwealth Ave Rear
Boston, MA 02215-1394
Phone
(617) 358-3400
Fax
(617) 358-3710
NPI assigned
Jun 1, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 258669 MA
Sports Medicine (Family Medicine) Physician 207QS0010X 258669 MA Primary

Addresses

Primary practice location

915 Commonwealth Ave Rear
Boston, MA 02215-1394

Mailing address

801 Albany St FL G
Boston, MA 02119-3791

Other identifiers 1

IdentifierTypeStateIssuer
110103576AMedicaidMA

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
I20150805006507 MA Practitioner - Sports MedicinePractitioner - Family Practice 8022322031 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Sports MedicineAlso: Family Practice
Education
University of Chicago, Pritzker School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boston University Family Medicine IncGroup PAC ID 0446154074, 67 clinicians

Practice addresses (Care Compare)

1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (617) 414-4465

930 Commonwealth Ave
Boston, MA 02215-1274
Phone (617) 414-6800

Hospital & facility affiliations

  • Boston Medical Center Hospital, Boston, MA, CCN 220031

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Medical Center Corporation Current Accepting new patients
Boston University Family Medicine, Inc. Family Medicine CurrentSince Aug 24, 2015 Accepting new patients

Locations

930 Commonwealth Ave
Boston, MA 02215
Phone (617) 262-2020

915 Commonwealth Ave
Rear
Boston, MA 02215
Phone (617) 358-3400

801 Albany St
Fl G
Roxbury, MA 02119

1 Boston Medical Ctr Pl
Roxbury, MA 02118
Phone (617) 414-5245

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

Interoperability endpoints

  • Direct secure messaging: ncardoos88279@direct.bmc.masshiway.net

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 and National Provider Directory roles.

Hospital & facility affiliations 8

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": "1306886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1083908685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 ALBANY ST FL G",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021193791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 COMMONWEALTH AVE REAR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022151394",
            "telephone_number": "617-358-3400",
            "fax_number": "617-358-3710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARDOOS",
        "first_name": "NATHAN",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-01",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "258669",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "MA",
            "license": "258669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110103576A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.