Individual provider Active NPI

Soravis Osataphan

  • Medical Oncology Physician
  • Boston, MA
National Provider Identifier
1164086518
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Oncology PhysicianTaxonomy code 207RX0202X
License
1023906 Issued in MA
Practice address
330 Brookline Ave
Boston, MA 02215-5400
Phone
(617) 499-5639
NPI assigned
Apr 30, 2019
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X 1023906 MA
Medical Oncology Physician 207RX0202X 1023906 MA Primary
Hematology (Internal Medicine) Physician 207RH0000X 1023906 MA

Addresses

Primary practice location

330 Brookline Ave
Boston, MA 02215-5400

Mailing address

330 Brookline Ave
Boston, MA 02215-5400
Phone (857) 707-5195

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
I20250814003096 MA Practitioner - Hematology/Oncology 8820494149 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

330 Brookline Ave
Boston, MA 02215-5400
Phone (617) 754-8612

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1023906MAMDMedical Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Dana-Farber Cancer Institute, Inc. CurrentSince Dec 1, 2025 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Sep 1, 2025 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Current Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Dec 1, 2025 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Sep 1, 2025 Accepting new patients
Dana-Farber Cancer Institute, Inc. Medical Oncology CurrentSince Dec 1, 2025 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Past Accepting new patients

Locations

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

330 Brookline Ave
#9
Boston, MA 02215
Phone (617) 667-2100

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

450 Brookline Ave
Boston, MA 02215
Phone (508) 478-2061

330 Mount Auburn St
Cambridge, MA 02138
Phone (617) 499-5054

Organizations & group practices 7

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1556582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759881600000",
    "number": "1164086518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "857-707-5195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-499-5639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSATAPHAN",
        "first_name": "SORAVIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-30",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "MA",
            "license": "1023906",
            "primary": false
        },
        {
            "code": "207RX0202X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Medical Oncology",
            "state": "MA",
            "license": "1023906",
            "primary": true
        },
        {
            "code": "207RH0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology",
            "state": "MA",
            "license": "1023906",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.