Active NPI
Mikhal Yudien, MD
- Surgery Physician
- Boston, MA
National Provider Identifier
1205687720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 3016529
- Practice address
- 55 Fruit Street
GRB-425
Boston, MA 02114 - Phone
- (617) 726-2800
- NPI assigned
- Apr 1, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 3016529 | MA | Primary |
Addresses
Primary practice location
55 Fruit Street
GRB-425
Boston, MA 02114
Mailing address
502 Mikhal Dr
Waitsfield, VT 05673-7286
Phone (802) 793-1411
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240628000483 | MA | Order and Referring Only - General Surgery | 8325582596 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3016529 | MA | MD | Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711929600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1711929600000",
"number": "1205687720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "502 MIKHAL DR",
"city": "WAITSFIELD",
"state": "VT",
"postal_code": "056737286",
"telephone_number": "802-793-1411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 FRUIT STREET",
"address_2": "GRB-425",
"city": "BOSTON",
"state": "MA",
"postal_code": "02114",
"telephone_number": "617-726-2800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YUDIEN",
"first_name": "MIKHAL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-01",
"last_updated": "2024-04-01",
"certification_date": "2024-03-27",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MA",
"license": "3016529",
"primary": true
}
],
"identifiers": [],
"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 Apr 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.