NPIMap

Organization Active NPI

Dana-Farber Cancer Institute, Inc.

  • Community/Retail Pharmacy
  • Chestnut Hill, MA
National Provider Identifier
1104437896
Registry record updated Jan 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
DANA-FARBER CANCER INSTITUTE, INC.
Practice address
300 Boylston St Ste 310
Chestnut Hill, MA 02467-1959
Phone
(617) 632-3878
NPI assigned
Aug 14, 2020
Organization subpart
Yes
Parent organization
DANA-FARBER CANCER INSTITUTE, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 28, 2021

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

Authorized official

Name
Jason James Poquette, RPH
Title
Director of Specialty Pharmacy
Phone
(508) 234-4366

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

300 Boylston St Ste 310
Chestnut Hill, MA 02467-1959

Mailing address

300 Boylston St Ste 310
Chestnut Hill, MA 02467-1959

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210309002873 MA DME Supplier - HospitalDME Supplier - Pharmacy 9133038904 Practice locations: Chestnut Hill, MA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Sidney Farber Cancer Ce15 organizations share this tax ID, including this one
Part of
Sidney Farber Cancer Ce

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

300 Boylston St
Ste 310
Chestnut Hill, MA 02467
Phone (617) 485-5922

NPI Registry JSON

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

{
    "created_epoch": "1597363200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611792000000",
    "number": "1104437896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 BOYLSTON ST STE 310",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024671959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BOYLSTON ST STE 310",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024671959",
            "telephone_number": "617-632-3878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DANA-FARBER CANCER INSTITUTE, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "DANA-FARBER CANCER INSTITUTE, INC.",
        "enumeration_date": "2020-08-14",
        "last_updated": "2021-01-28",
        "certification_date": "2021-01-28",
        "status": "A",
        "authorized_official_last_name": "POQUETTE",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "DIRECTOR OF SPECIALTY PHARMACY",
        "authorized_official_telephone_number": "508-234-4366",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chestnut Hill, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.