NPIMap

Organization Active NPI

Massachusetts General Hospital Oral & Maxillofacial Surgery

  • General Acute Care Hospital
  • Boston, MA
National Provider Identifier
1144509209
Registry record updated Aug 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
License
P-36801 Issued in MA
Legal business name
MASSACHUSETTS GENERAL HOSPITAL ORAL & MAXILLOFACIAL SURGERY
Practice address
55 Fruit St
Wang Ambulatory Building Suite 230
Boston, MA 02114-2621
Phone
(617) 726-8222
NPI assigned
Aug 8, 2011
Last updated
Aug 8, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2011

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

Authorized official

Name
Dr. Leonard Bruce Kaban, M.D.NPI 1902897325
Title
Chief
Phone
(617) 726-2740

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery Clinic/Center 261QS0112X NU
General Acute Care Hospital 282N00000X P-36801 MA Primary

Addresses

Primary practice location

55 Fruit St
Wang Ambulatory Building Suite 230
Boston, MA 02114-2621

Mailing address

55 Fruit St
Wang Ambulatory Building Suite 230
Boston, MA 02114-2621

Other identifiers 1

IdentifierTypeStateIssuer
110008955/BMedicaidMA

National Provider Directory

National Provider Directory

Locations

55 Fruit St
Ste 230
Boston, MA 02114
Phone (617) 726-2740

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1312761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312761600000",
    "number": "1144509209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "WANG AMBULATORY BUILDING SUITE 230",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "address_2": "WANG AMBULATORY BUILDING SUITE 230",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-8222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASSACHUSETTS GENERAL HOSPITAL ORAL & MAXILLOFACIAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-08",
        "last_updated": "2011-08-08",
        "status": "A",
        "authorized_official_last_name": "KABAN",
        "authorized_official_first_name": "LEONARD",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "617-726-2740",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "MA",
            "license": "P-36801",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110008955/B",
            "state": "MA"
        }
    ],
    "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 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.