Active NPI
Mark A Flomenbaum, M.D.
- Forensic Pathology Physician
- Boston, MA
National Provider Identifier
1447207774
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Pathology Physician
- License
- 72296
- Practice address
- 72 E Concord St
Building 'L' -- Room 805-C
Boston, MA 02118-2394 - Phone
- (617) 267-6767
- NPI assigned
- May 30, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Pathology Physician | 207ZF0201X | 72296 | MA | Primary |
Addresses
Primary practice location
72 E Concord St
Building 'L' -- Room 805-C
Boston, MA 02118-2394
Mailing address
72 E Concord St
Building 'L' -- Room 805-C
Boston, MA 02118-2394
Phone (617) 638-4505
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 72296 | MA | MD | Forensic Pathology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148947200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252540800000",
"number": "1447207774",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "72 E CONCORD ST",
"address_2": "BUILDING 'L' -- ROOM 805-C",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182394",
"telephone_number": "617-638-4505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "72 E CONCORD ST",
"address_2": "BUILDING 'L' -- ROOM 805-C",
"city": "BOSTON",
"state": "MA",
"postal_code": "021182394",
"telephone_number": "617-267-6767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FLOMENBAUM",
"first_name": "MARK",
"middle_name": "A",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-30",
"last_updated": "2009-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "207ZF0201X",
"taxonomy_group": "",
"desc": "Pathology, Forensic Pathology",
"state": "MA",
"license": "72296",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.