Individual provider Active NPI

Christopher Hardy Fanta, MD

  • Pulmonary Disease Physician
  • Boston, MA
National Provider Identifier
1144267733
Registry record updated Jul 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
45769 Issued in MA
Practice address
15 Francis St.
Boston, MA 02115
Phone
(617) 732-6770
Fax
(617) 582-6102
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 45769 MA Primary

Addresses

Primary practice location

15 Francis St.
Boston, MA 02115

Mailing address

111 Cypress St
Brookline, MA 02445-6002
Phone (857) 307-0896

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080710000277 MA Practitioner - Pulmonary Disease 6002988813 Reassigns benefits to 2 organizations
I20150526000403 TX Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 6002988813 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
45769MAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Hospital, Inc. CurrentSince Sep 1, 2008 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince May 11, 2015 Accepting new patients
DHHS, PHS, Naihs, Shiprock Hospital CurrentSince May 11, 2015 Accepting new patients

Locations

221 Longwood Ave
Boston, MA 02115
Phone (617) 732-4918

75 Francis St
Boston, MA 02115

375 Boylston St
Brookline, MA 02445
Phone (508) 718-4010

399 Revolution Dr
Somerville, MA 02145
Phone (800) 856-1983

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341360000000",
    "number": "1144267733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 CYPRESS ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024456002",
            "telephone_number": "857-307-0896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 FRANCIS ST.",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02115",
            "telephone_number": "617-732-6770",
            "fax_number": "617-582-6102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANTA",
        "first_name": "CHRISTOPHER",
        "middle_name": "HARDY",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2012-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MA",
            "license": "45769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.