Individual provider Active NPI

Christopher Paul Deangelis, MD

  • Pediatrics Physician
  • Somerville, MA
National Provider Identifier
1376534388
Registry record updated Dec 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
154686 Issued in MA
Practice address
300 Broadway
Somerville Pediatrics
Somerville, MA 02145-2935
Phone
(617) 284-7000
NPI assigned
Oct 31, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 154686 MA Primary

Addresses

Primary practice location

300 Broadway
Somerville Pediatrics
Somerville, MA 02145-2935

Mailing address

300 Broadway
Somerville Pediatrics
Somerville, MA 02145-2935
Phone (617) 284-7000

Other identifiers 2

IdentifierTypeStateIssuer
3175006MedicaidMA
J18691OtherMABCBS MA

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
I20050901000647 MA Practitioner - Pediatric Medicine 4486686151 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
154686MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. Pediatrics Current Accepting new patients
Atrius Health, Inc. Pediatrics CurrentSince Dec 1, 2013 Accepting new patients
Atrius Health, Inc. CurrentSince Dec 1, 2013 Accepting new patients
Cambridge Public Health Commission Past Accepting new patients
Cambridge Public Health Commission Past Accepting new patients
Atrius Health, Inc. Pediatrics Past Accepting new patients

Locations

147 Milk St
Boston, MA 02109
Phone (617) 421-2508

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

485 Arsenal St
Watertown, MA 02472
Phone (617) 972-5100

Interoperability endpoints

  • Direct secure messaging: cdeangelismd20815@direct.atrius.masshiway.net

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": "1130716800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322784000000",
    "number": "1376534388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 BROADWAY",
            "address_2": "SOMERVILLE PEDIATRICS",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021452935",
            "telephone_number": "617-284-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 BROADWAY",
            "address_2": "SOMERVILLE PEDIATRICS",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021452935",
            "telephone_number": "617-284-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEANGELIS",
        "first_name": "CHRISTOPHER",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-31",
        "last_updated": "2011-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "154686",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3175006",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "J18691",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

Verify at the official NPI Registry.