Individual provider Active NPI

Candan Yorgancioglu, M.D.

  • Internal Medicine Physician
  • Medford, MA
National Provider Identifier
1306804901
Registry record updated Feb 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
226438 Issued in MA
Practice address
101 Main St
Suite 116
Medford, MA 02155-4540
Phone
(781) 396-2000
Fax
(781) 391-2619
NPI assigned
May 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 226438 MA Primary

Addresses

Primary practice location

101 Main St
Suite 116
Medford, MA 02155-4540

Mailing address

101 Main St
Suite 116
Medford, MA 02155-4540
Phone (781) 396-2000

Other identifiers 5

IdentifierTypeStateIssuer
0037589OtherMANEIGHBORHOOD HEALTH
2115247MedicaidMA
494601OtherMATUFTS
J29856OtherMABLUE CROSS
AA55156OtherMAHARVARD PILGRIM

Other names 1

  • Candan Zaimoglu Former name

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
I20060524000216 MA Practitioner - Internal Medicine 4789695107 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
226438MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hallmark Health Medical Associates Inc Internal Medicine CurrentSince Mar 3, 2014 Accepting new patients
Hallmark Health System Inc Internal Medicine Past Accepting new patients

Locations

101 Main St
Ste 116
Medford, MA 02155
Phone (781) 391-2121

101 Main St
Ste 204
Medford, MA 02155
Phone (781) 395-2114

425 Revere St
Revere, MA 02151
Phone (781) 286-1313

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392940800000",
    "number": "1306804901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MAIN ST",
            "address_2": "SUITE 116",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554540",
            "telephone_number": "781-396-2000",
            "fax_number": "781-391-2619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MAIN ST",
            "address_2": "SUITE 116",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554540",
            "telephone_number": "781-396-2000",
            "fax_number": "781-391-2619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YORGANCIOGLU",
        "first_name": "CANDAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-03",
        "last_updated": "2014-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "226438",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH",
            "identifier": "0037589",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2115247",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "494601",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "J29856",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "AA55156",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CANDAN",
            "last_name": "ZAIMOGLU",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Medford, MA

Sources for this page

Verify at the official NPI Registry.