Individual provider Active NPI

Akshay Sanan, MD

  • Facial Plastic Surgery Physician
  • Boston, MA
National Provider Identifier
1174966188
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Facial Plastic Surgery PhysicianTaxonomy code 207YS0123X
License
281308 Issued in MA
Practice address
69 Newbury St Ste 5
Boston, MA 02116-3066
Phone
(617) 450-0070
NPI assigned
Apr 9, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X A155775 CA
Facial Plastic Surgery Physician 207YS0123X 281308 MA Primary

Addresses

Primary practice location

69 Newbury St Ste 5
Boston, MA 02116-3066

Mailing address

69 Newbury St Ste 5
Boston, MA 02116-3066
Phone (617) 450-0070

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180606002642 CA Practitioner - Otolaryngology 7618100645

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A155775CAMDOtolaryngology Physician
281308MAMDFacial Plastic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1365465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1174966188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 NEWBURY ST STE 5",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021163066",
            "telephone_number": "617-450-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 NEWBURY ST STE 5",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021163066",
            "telephone_number": "617-450-0070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANAN",
        "first_name": "AKSHAY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-04-09",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "CA",
            "license": "A155775",
            "primary": false
        },
        {
            "code": "207YS0123X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Facial Plastic Surgery",
            "state": "MA",
            "license": "281308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.