Individual provider Active NPI

Jack Qian, MD

  • Radiation Oncology Physician
  • Boston, MA
National Provider Identifier
1174054787
Registry record updated Mar 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
License
281685 Issued in MA
Practice address
75 Francis St
Boston, MA 02115-6110
Phone
(617) 732-5500
NPI assigned
Mar 24, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X 281685 MA Primary

Addresses

Primary practice location

75 Francis St
Boston, MA 02115-6110

Mailing address

382 Riverway Apt 4
Boston, MA 02115-6436
Phone (518) 391-3107

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
I20220622001187 MA Practitioner - Radiation Oncology 9739430505 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Yale University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Brigham and Womens Physicians Organization IncGroup PAC ID 3870405988, 2,931 clinicians
Radiation Therapy of Southeastern Mass, LLCGroup PAC ID 9335248343, 10 clinicians

Practice addresses (Care Compare)

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

89 Forbes Blvd
Mansfield, MA 02048-1125

89 Forbes Blvd
Mansfield, MA 02048-1281
Phone (857) 307-3700

Hospital & facility affiliations

  • Dana-Farber Cancer Institute Hospital, Boston, MA, CCN 220162
  • South Shore Hospital Hospital, South Weymouth, MA, CCN 220100
  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110
  • Sturdy Memorial Hospital Hospital, Attleboro, MA, CCN 220008

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Radiation Therapy of Southeastern Mass, LLC CurrentSince Sep 1, 2023 Accepting new patients
Brigham & Womens Physicians Organization Inc Radiation Oncology CurrentSince Aug 1, 2022 Accepting new patients
Brigham and Women'S Hospital Current Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Jul 1, 2022 Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Jul 1, 2022 Accepting new patients
Dana-Farber Cancer Institute, Inc. Past Accepting new patients

Locations

75 Francis St
Boston, MA 02115

55 Fruit St
Boston, MA 02114

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

89 Forbes Blvd
Mansfield, MA 02048
Phone (857) 307-3700

254 2nd Ave
Ste 100
Needham Heights, MA 02494
Phone (781) 416-8412

Interoperability endpoints

  • Direct secure messaging: qian.jack.bwh@direct.partners.masshiway.net

Organizations & group practices 6

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 4

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": "1490313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1174054787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "382 RIVERWAY APT 4",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156436",
            "telephone_number": "518-391-3107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156110",
            "telephone_number": "617-732-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QIAN",
        "first_name": "JACK",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-24",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MA",
            "license": "281685",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.