Individual provider Active NPI

Kathryn Young Noonan, M.D.

  • Otolaryngology Physician
  • Boston, MA
National Provider Identifier
1265799100
Registry record updated Apr 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
277986 Issued in MA
Practice address
800 Washington St
Boston, MA 02111
Phone
(617) 636-5000
NPI assigned
Apr 17, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 277986 MA Primary

Addresses

Primary practice location

800 Washington St
Boston, MA 02111

Mailing address

800 Washington St
Boston, MA 02111-1552
Phone (617) 636-5000

Other practice location 1

1 Medical Center Dr
DHMC Department of Otolaryngology
Lebanon, NH 03756-1000
Phone (603) 650-5000

Other practice location 2

1 Medical Center Dr
DHMC Department of Otolaryngology
Lebanon, NH 03756-1000
Phone (603) 650-5000

Other practice location 3

299 Faunce Corner Rd
North Dartmouth, MA 02747-6244
Phone (508) 995-0700

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address knoonan47362@direct.southcoast.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180226002048 CA Practitioner - Otolaryngology 5294033460 Reassigns benefits to 1 organization
I20190606001733 MA Practitioner - Otolaryngology 5294033460 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Albany Medical College of Union University, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Associates in Otolaryngology Head and Neck Surgery, PCGroup PAC ID 6507839438, 9 clinicians

Practice addresses (Care Compare)

100 MLK Jr Blvd
Suite 4
Worcester, MA 01608-1209
Phone (508) 757-0330

800 Washington St
Boston, MA 02111-1552
Phone (617) 636-8137

Hospital & facility affiliations

  • Tufts Medical Center Hospital, Boston, MA, CCN 220116
  • St Vincent Hospital Hospital, Worcester, MA, CCN 220176
  • Umass Memorial Health - Harrington Hospital Hospital, Southbridge, MA, CCN 220019

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
277986MAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Physicians Group, Inc. CurrentSince Aug 20, 2019 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Aug 20, 2019 Accepting new patients
Associates in Otolaryngology Head and Neck Surgery PC Otolaryngology CurrentSince Aug 1, 2019 Accepting new patients
County of Los Angeles CurrentSince Feb 15, 2018 Accepting new patients
County of Los Angeles CurrentSince Feb 15, 2018 Accepting new patients
Pratt Otolaryngology- Head & Neck Surgery Associates Inc Otolaryngology CurrentSince Jul 1, 2019 Accepting new patients

Locations

14445 Olive View Dr
#2C155
Sylmar, CA 91342
Phone (818) 364-3001

14445 Olive View Dr
Sylmar, CA 91342
Phone (881) 836-4303

800 Washington St
#1
Boston, MA 02111

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

299 Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 995-0700

100 Mlk Jr Blvd
Ste 4
Worcester, MA 01608
Phone (508) 757-0330

48 Elm St
Worcester, MA 01609
Phone (508) 757-0330

100 Mlk Jr Blvd
Worcester, MA 01608
Phone (508) 754-3823

Interoperability endpoints

  • Direct secure messaging: knoonan29464@tuftsmedicine.direct-ci.com
  • Direct secure messaging: knoonan47362@direct.southcoast.org

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 3

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": "1334620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587600000000",
    "number": "1265799100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-5000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02111",
            "telephone_number": "617-636-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Center Dr",
            "address_2": "DHMC Department of Otolaryngology",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "NH",
            "postal_code": "037561000",
            "country_code": "US",
            "telephone_number": "603-650-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Medical Center Dr",
            "address_2": "DHMC Department of Otolaryngology",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "NH",
            "postal_code": "037561000",
            "country_code": "US",
            "telephone_number": "603-650-5000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "299 Faunce Corner Rd",
            "address_purpose": "LOCATION",
            "city": "North Dartmouth",
            "state": "MA",
            "postal_code": "027476244",
            "country_code": "US",
            "telephone_number": "508-995-0700",
            "fax_number": "508-973-1355",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOONAN",
        "first_name": "KATHRYN",
        "middle_name": "YOUNG",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-17",
        "last_updated": "2020-04-23",
        "certification_date": "2020-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MA",
            "license": "277986",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "knoonan47362@direct.southcoast.org",
            "affiliation": "N",
            "endpointDescription": "Southcoast Health Epic Direct Address",
            "address_1": "299 Faunce Corner Rd",
            "city": "North Dartmouth",
            "state": "MA",
            "country_code": "US",
            "postal_code": "027476244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.