Individual provider Active NPI

Chandni Patel

  • Pediatric Nurse Practitioner
  • Boston, MA
National Provider Identifier
1497330286
Registry record updated Oct 20, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
RN2306939 Issued in MA
Practice address
354 Tremont St
Boston, MA 02116-5538
Phone
(617) 426-9200
NPI assigned
Mar 12, 2021
Last updated
Oct 20, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X RN2306939 MA Primary

Addresses

Primary practice location

354 Tremont St
Boston, MA 02116-5538

Mailing address

354 Tremont St
Boston, MA 02116-5538
Phone (617) 426-9200

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230811001830 MA Practitioner - Nurse Practitioner 9537521224 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Health Services, Inc. CurrentSince Jun 28, 2023 Accepting new patients
Harbor Health Services, Inc. CurrentSince Jun 28, 2023 Accepting new patients
Pratt Pediatric Associates Inc PastSince Oct 24, 2021 Accepting new patients
Porter Pediatrics Comprehensive Pediatric Health Care.PC PastSince Oct 24, 2021 Accepting new patients

Locations

250 Mount Vernon St
Dorchester, MA 02125
Phone (617) 288-1140

398 Neponset Ave
Dorchester, MA 02122
Phone (617) 282-3200

1135 Morton St
Mattapan, MA 02126
Phone (617) 533-2300

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1615507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634688000000",
    "number": "1497330286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "354 TREMONT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021165538",
            "telephone_number": "617-426-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 TREMONT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021165538",
            "telephone_number": "617-426-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATEL",
        "first_name": "CHANDNI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-12",
        "last_updated": "2021-10-20",
        "certification_date": "2021-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MA",
            "license": "RN2306939",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.