Jonathan Xinguo Fang, MBBS

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

294223 Issued in MA

Practice address

75 Francis St
Boston, MA 02115-6106

Phone

(617) 821-8230

NPI assigned

Apr 7, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1649289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662422400000",
    "number": "1407598857",
    "addresses": [
        {
            "country_code": "HK",
            "country_name": "Hong Kong",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "K1930, BLOCK K, QUEEN MARY HOSPITAL, 102 POKFULAM ROAD",
            "address_2": "POKFULAM, HONG KONG",
            "city": "HONG KONG",
            "state": "HONG KONG",
            "postal_code": "999077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156106",
            "telephone_number": "617-821-8230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANG",
        "first_name": "JONATHAN",
        "middle_name": "XINGUO",
        "name_prefix": "Dr.",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-07",
        "last_updated": "2022-09-06",
        "certification_date": "2022-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "MA",
            "license": "PENDING",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MA",
            "license": "294223",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "N/A",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "75 Francis St",
            "city": "Boston",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021156106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christopher Fanelli, D.D.S.
• Kimberly Ann Fanelli, M.S.
• Amy Fang, P.A -C
• Angela Fang, PH.D.
• Anna P Fang, MD
• Leslie Shu-Tung Fang, MD
• Lyla Fanger, LICSW
• Calleigh Fangmeyer, ATC
• Grace Rose Fanikos
• Gary Fanjiang, MD

• Student in an Organized Health Care Education/Training Program in Boston, MA
• Providers in Boston, MA by specialty
• Student in an Organized Health Care Education/Training Program in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.