Individual provider Active NPI

Samuel Joseph Andonian, MD

  • Pediatric Adolescent Medicine Physician
  • Lexington, MA
National Provider Identifier
1326065384
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
37648 Issued in MA
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, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
2025698MedicaidMA
037648OtherMATUFTS
D28132OtherMABSBS 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

LicenseStateTypeSpecialty
37648MAMDPediatric 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.

Verify at the official NPI Registry.