Individual provider Active NPI

Manish Tandon, MD

  • Gastroenterology Physician
  • Somerville, MA
National Provider Identifier
1417021437
Registry record updated Nov 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
155573 Issued in MA
Practice address
230 Highland Ave
Medical Specialties
Somerville, MA 02143-1408
Phone
(617) 665-1552
NPI assigned
Nov 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 155573 MA Primary

Addresses

Primary practice location

230 Highland Ave
Medical Specialties
Somerville, MA 02143-1408

Mailing address

230 Highland Ave
Medical Specialties
Somerville, MA 02143-1408
Phone (617) 665-1552

Other identifiers 2

IdentifierTypeStateIssuer
J24432OtherMABCBS MA
0186619MedicaidMA

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
I20040406001287 MA Practitioner - GastroenterologyPractitioner - Nephrology 8426041302 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Nephrology
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

103 Garland St
Everett, MA 02149-5066
Phone (617) 389-6270

11 Nevins St
Brighton, MA 02135-3514
Phone (617) 562-0500

1493 Cambridge St
Cambridge, MA 02139-1047
Phone (617) 665-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
24.26 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
80.86

Merit-based Incentive Payment System (MIPS)

Final score
91.27 of 100Reported as group
Quality
77.51
Promoting interoperability
100
Improvement activities
40
Cost
76.72

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy105
Upper gastrointestinal (GI) endoscopy for acid reflux93

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
155573MAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Manish Tandon, MD,Associates PC CurrentSince Dec 10, 2009 Accepting new patients
Cambridge Public Health Commission Past Accepting new patients
Gastroenterology & Hepatology Associates, P. C. Gastroenterology PastSince Oct 21, 2012 Accepting new patients

Locations

11 Nevins St
Ste 304
Brighton, MA 02135
Phone (617) 562-0500

300 Mount Auburn St
Ste 406
Cambridge, MA 02138
Phone (617) 499-0026

Interoperability endpoints

  • Direct secure messaging: mtandon560368@direct.bilh.masshiway.net
  • Direct secure messaging: mtandon263830@direct.bmc.masshiway.net

Organizations & group practices 4

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 3

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": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195084800000",
    "number": "1417021437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 HIGHLAND AVE",
            "address_2": "MEDICAL SPECIALTIES",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021431408",
            "telephone_number": "617-665-1552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 HIGHLAND AVE",
            "address_2": "MEDICAL SPECIALTIES",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021431408",
            "telephone_number": "617-665-1552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANDON",
        "first_name": "MANISH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2007-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MA",
            "license": "155573",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "J24432",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0186619",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

Verify at the official NPI Registry.