Individual provider Active NPI

Om P Ganda, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Boston, MA
National Provider Identifier
1134298938
Registry record updated May 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
35771 Issued in MA
Practice address
1 Joslin PL
Boston, MA 02215-5306
Phone
(617) 732-2508
Fax
(617) 732-2452
NPI assigned
Nov 7, 2006
Last updated
May 4, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 35771 MA Primary

Addresses

Primary practice location

1 Joslin PL
Boston, MA 02215-5306

Mailing address

One Joslin Place
Boston, MA 02215-5306
Phone (617) 309-2400

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
I20051029000008 MA Practitioner - Endocrinology 9931126869 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35771MAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Joslin Clinic Inc CurrentSince Oct 1, 1973 Accepting new patients

Locations

1 Joslin Pl
Boston, MA 02215
Phone (617) 309-2400

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304467200000",
    "number": "1134298938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE JOSLIN PLACE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155306",
            "telephone_number": "617-309-2400",
            "fax_number": "617-732-2452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 JOSLIN PL",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155306",
            "telephone_number": "617-732-2508",
            "fax_number": "617-732-2452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GANDA",
        "first_name": "OM",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2011-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MA",
            "license": "35771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.