Individual provider Active NPI

Michael J Yaremchuk, MD

  • Plastic Surgery Physician
  • Boston, MA
National Provider Identifier
1326038977
Registry record updated May 31, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
41996 Issued in MA
Practice address
15 Parkman St
MGH Wacc Suite 435
Boston, MA 02114-3117
Phone
(978) 535-6043
Fax
(978) 535-6047
NPI assigned
Oct 25, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery Physician 208200000X 41996 MA Primary

Addresses

Primary practice location

15 Parkman St
MGH Wacc Suite 435
Boston, MA 02114-3117

Mailing address

15 Parkman St
MGH Wacc Suite 435
Boston, MA 02114-3117
Phone (978) 535-6043

Other identifiers 3

IdentifierTypeStateIssuer
J06963OtherMABCBS MA
3029662MedicaidMA
041996OtherMATUFTS HEALTH PLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41996MAMDPlastic Surgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1130198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306800000000",
    "number": "1326038977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 PARKMAN ST",
            "address_2": "MGH WACC SUITE 435",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021143117",
            "telephone_number": "978-535-6043",
            "fax_number": "978-535-6047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 PARKMAN ST",
            "address_2": "MGH WACC SUITE 435",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021143117",
            "telephone_number": "978-535-6043",
            "fax_number": "978-535-6047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YAREMCHUK",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-25",
        "last_updated": "2011-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MA",
            "license": "41996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "J06963",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3029662",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "041996",
            "state": "MA"
        }
    ],
    "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 May 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.