Active NPI
Ara Ketchedjian, M.D.
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Boston, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- License
- 219989
- Practice address
- 850 Harrison Ave
Yacc BN-C7
Boston, MA 02118-4001 - Phone
- (617) 414-5405
- Fax
- (617) 414-6031
- NPI assigned
- Jan 30, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | 208G00000X | 219989 | MA | Primary |
| Surgery Physician | 208600000X | 219989 | MA |
Addresses
Primary practice location
850 Harrison Ave
Yacc BN-C7
Boston, MA 02118-4001
Mailing address
850 Harrison Ave
Yacc BN-C7
Boston, MA 02118-4001
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110075849A | Medicaid | 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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Cardiac Surgery
- Education
- State University of Ny Upstate Medical University, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
27 Park St
Hyannis, MA 02601-5230
Phone (774) 552-6000
Hospital & facility affiliations
- Cape Cod Hospital
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Coronary artery bypass graft (CABG) | 15 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 219989 | MA | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Steward Medical Group, Inc | Current | Accepting new patients | |
| Physicians of Cape Cod Hospital | Current | Accepting new patients | |
| Steward Medical Group, Inc | Current | Accepting new patients | |
| Boston University Cardiac and Thoracic Surgical Foundation, Inc. | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Past | Accepting new patients |
| Cape Cod Hospital Inc | Past | Accepting new patients | |
| Steward Medical Group Inc. | Past | Accepting new patients |
Locations
88 Newton St
Boston, MA 02118
Phone (617) 638-7350
77 Warren St
Fl 5
Brighton, MA 02135
Phone (617) 254-3376
11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442
27 Park St
Hyannis, MA 02601
Phone (508) 775-5011
60A Park St
Hyannis, MA 02601
Phone (508) 771-4100
100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157
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.
-
- Neuroradiology Physician
- Hyannis, MA
- NPI 1679832364
-
- Specialist
- Watertown, MA
- NPI 1629398219
-
- Specialist
- Brighton, MA
- NPI 1356654495
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Boston, MA
- NPI 1407892078
-
- General Acute Care Hospital
- Hyannis, MA
- NPI 1114984671
-
- Cardiac Rehabilitation Clinic/Center
- Brighton, MA
- NPI 1760086599
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Hyannis, MA
- NPI 1114984671
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170115200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383782400000",
"number": "1467599720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 HARRISON AVE",
"address_2": "YACC BN-C7",
"city": "BOSTON",
"state": "MA",
"postal_code": "021184001"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "850 HARRISON AVE",
"address_2": "YACC BN-C7",
"city": "BOSTON",
"state": "MA",
"postal_code": "021184001",
"telephone_number": "617-414-5405",
"fax_number": "617-414-6031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KETCHEDJIAN",
"first_name": "ARA",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-30",
"last_updated": "2013-11-07",
"status": "A"
},
"taxonomies": [
{
"code": "208G00000X",
"taxonomy_group": "",
"desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
"state": "MA",
"license": "219989",
"primary": true
},
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MA",
"license": "219989",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110075849A",
"state": "MA"
}
],
"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 Nov 7, 2013; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.