Active NPI
Samuel Joseph Andonian, MD
- Pediatric Adolescent Medicine Physician
- Lexington, MA
National Provider Identifier
1326065384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- 37648
- Practice address
- 16 Clarke St
Lexington, MA 02421-4948 - Phone
- (781) 862-3218
- Fax
- (781) 862-0805
- NPI assigned
- Jul 16, 2006
- Last updated
- Sep 11, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 37648 | MA | |
| Pediatric Adolescent Medicine Physician | 2080A0000X | 37648 | MA | Primary |
Addresses
Primary practice location
16 Clarke St
Lexington, MA 02421-4948
Mailing address
16 Clarke St
Lexington, MA 02421-4948
Phone (781) 862-3218
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2025698 | Medicaid | MA | |
| 037648 | Other | MA | TUFTS |
| D28132 | Other | MA | BSBS 20465 MASS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 37648 | MA | MD | Pediatric Adolescent Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153008000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1326065384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16 CLARKE ST",
"city": "LEXINGTON",
"state": "MA",
"postal_code": "024214948",
"telephone_number": "781-862-3218",
"fax_number": "781-862-0805"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16 CLARKE ST",
"city": "LEXINGTON",
"state": "MA",
"postal_code": "024214948",
"telephone_number": "781-862-3218",
"fax_number": "781-862-0805"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDONIAN",
"first_name": "SAMUEL",
"middle_name": "JOSEPH",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-16",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "37648",
"primary": false
},
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "MA",
"license": "37648",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2025698",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "037648",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BSBS 20465 MASS",
"identifier": "D28132",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lexington, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.