Individual provider Active NPI

Christina Theodoris, M.D., PH.D.

  • Student in an Organized Health Care Education/Training Program
  • Boston, MA
National Provider Identifier
1316488752
Registry record updated Mar 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
300 Longwood Ave
BCH, Hunnewell BLDG, Pavilion 129, Housestaff Lounge
Boston, MA 02115-5724
Phone
(617) 355-6000
NPI assigned
Mar 18, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

300 Longwood Ave
BCH, Hunnewell BLDG, Pavilion 129, Housestaff Lounge
Boston, MA 02115-5724

Mailing address

300 Longwood Ave
BCH, Hunnewell BLDG, Pavilion 129, Housestaff Lounge
Boston, MA 02115-5724

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20231027001596 CA Practitioner - Pediatric Medicine 4880040815 Reassigns benefits to 3 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Pediatrics Associates CurrentSince Oct 3, 2023 Accepting new patients
University of California San Francisco CurrentSince Oct 3, 2023 Accepting new patients
University of California San Francisco CurrentSince Oct 3, 2023 Accepting new patients
UCSF Medical Group Business Services CurrentSince Oct 3, 2023 Accepting new patients
University of California San Francisco Current Accepting new patients
UCSF Medical Group Business Services CurrentSince Oct 3, 2023 Accepting new patients

Locations

3100 San Pablo Ave
Berkeley, CA 94702
Phone (510) 985-5020

505 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-9058

400 Parnassus Ave
#A632
San Francisco, CA 94143
Phone (415) 473-1000

2001 The Embarcadero
Ste 1500
San Francisco, CA 94143
Phone (415) 353-1606

2330 Post St
San Francisco, CA 94115
Phone (415) 502-4444

Interoperability endpoints

  • Direct secure messaging: ctheodoris9366@direct-ucsfmedicalcenter.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.

NPI Registry JSON

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

{
    "created_epoch": "1489795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1489795200000",
    "number": "1316488752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "address_2": "BCH, HUNNEWELL BLDG, PAVILION 129, HOUSESTAFF LOUNGE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "address_2": "BCH, HUNNEWELL BLDG, PAVILION 129, HOUSESTAFF LOUNGE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEODORIS",
        "first_name": "CHRISTINA",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-18",
        "last_updated": "2017-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.