Active NPI
Lisa Iannattone, MD
- Dermatology Physician
- Boston, MA
National Provider Identifier
1114442548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 271066
- Practice address
- 221 Longwood Ave
Boston, MA 02115-5804 - Phone
- (617) 582-6060
- NPI assigned
- Aug 7, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 271066 | MA | Primary |
Addresses
Primary practice location
221 Longwood Ave
Boston, MA 02115-5804
Mailing address
80 Fenwood Rd Unit 716
Boston, MA 02115-6150
Phone (617) 543-5493
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 271066 | MA | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502064000000",
"number": "1114442548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "80 FENWOOD RD UNIT 716",
"city": "BOSTON",
"state": "MA",
"postal_code": "021156150",
"telephone_number": "617-543-5493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "221 LONGWOOD AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021155804",
"telephone_number": "617-582-6060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IANNATTONE",
"first_name": "LISA",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-07",
"last_updated": "2017-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MA",
"license": "271066",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}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 Aug 7, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.