Individual provider Active NPI

Antonio R Perez-Atayde, MD

  • Anatomic Pathology Physician
  • Boston, MA
National Provider Identifier
1164433207
Registry record updated Aug 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology PhysicianTaxonomy code 207ZP0101X
License
43903 Issued in MA
Practice address
300 Longwood Ave
Bader 1
Boston, MA 02115-5724
Phone
(617) 355-7431
NPI assigned
Aug 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology Physician 207ZP0101X 43903 MA Primary
Pediatric Pathology Physician 207ZP0213X 43903 MA

Addresses

Primary practice location

300 Longwood Ave
Bader 1
Boston, MA 02115-5724

Mailing address

300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-6000

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
I20060407000383 MA Practitioner - Pathology 9537178264 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 1974
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Children'S Hospital Pathology Foundation IncGroup PAC ID 0143292730, 15 clinicians

Practice addresses (Care Compare)

300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-6000

Hospital & facility affiliations

  • Boston Children'S Hospital Hospital, Boston, MA, CCN 223302

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Pathology Foundation, Inc. CurrentSince Mar 19, 1998 Accepting new patients

Locations

300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956

300 Longwood Ave
#1
Boston, MA 02115
Phone (617) 355-6624

Interoperability endpoints

  • Direct secure messaging: aperezatayde21889@direct.bostonchildrens.org

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 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": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187568000000",
    "number": "1164433207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "address_2": "BADER 1",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-7431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ-ATAYDE",
        "first_name": "ANTONIO",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0101X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology",
            "state": "MA",
            "license": "43903",
            "primary": true
        },
        {
            "code": "207ZP0213X",
            "taxonomy_group": "",
            "desc": "Pathology, Pediatric Pathology",
            "state": "MA",
            "license": "43903",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.