NPIMap

Individual provider Active NPI

Rachel Cannon, MD

  • Obstetrics & Gynecology Physician
  • Boston, MA
National Provider Identifier
1407198617
Registry record updated Nov 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
269851 Issued in MA
Practice address
850 Harrison Ave
Yacc 5
Boston, MA 02118-4001
Phone
(617) 414-2000
Fax
(617) 414-5798
NPI assigned
Mar 26, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 269851 MA Primary

Addresses

Primary practice location

850 Harrison Ave
Yacc 5
Boston, MA 02118-4001

Mailing address

801 Albany Street
FL Ground
Boston, MA 02119-3791

Other practice location 1

4199 Washington Street
Roslindale, MA 02131
Phone (617) 323-4440

Other identifiers 2

IdentifierTypeStateIssuer
3125035OtherMANH OUT OF STATE MEDICAID
110122465AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170522002611 MA Practitioner - Obstetrics/Gynecology 0941509269 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Massachusetts Medical School, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (617) 414-2000

720 Harrison Ave
Suite 1105
Boston, MA 02118-2334
Phone (617) 414-2000

Hospital & facility affiliations

  • Boston Medical Center Hospital, Boston, MA, CCN 220031

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
269851MAMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Medical Center Corporation Current Accepting new patients
Boston University Obstetrics and Gynecology Foundation, Inc. Obstetrics & Gynecology CurrentSince Jul 1, 2017 Accepting new patients

Locations

850 Harrison Ave
#5
Boston, MA 02118
Phone (617) 414-2000

720 Harrison Ave
Ste 1105
Boston, MA 02118
Phone (617) 414-2000

720 Harrison Ave
#503
Roxbury, MA 02118
Phone 6174145404 ext. 2

Interoperability endpoints

  • Direct secure messaging: rcannon612250@direct.ochin.org
  • Direct secure messaging: rcannon99205@direct.bmc.masshiway.net

Organizations & group practices 3

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1364256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667520000000",
    "number": "1407198617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 ALBANY STREET",
            "address_2": "FL GROUND",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021193791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 HARRISON AVE",
            "address_2": "YACC 5",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021184001",
            "telephone_number": "617-414-2000",
            "fax_number": "617-414-5798"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4199 Washington Street",
            "address_purpose": "LOCATION",
            "city": "Roslindale",
            "state": "MA",
            "postal_code": "02131",
            "country_code": "US",
            "telephone_number": "617-323-4440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CANNON",
        "first_name": "RACHEL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-03-26",
        "last_updated": "2022-11-04",
        "certification_date": "2022-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "269851",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NH OUT OF STATE MEDICAID",
            "identifier": "3125035",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110122465A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.