Om Biju Panta, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

3017614 Issued in MA

Practice address

330 Brookline Ave
Boston, MA 02215-5491

Phone

(929) 434-0651

NPI assigned

Dec 28, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1735344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735344000000",
    "number": "1538977152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 PARK DR APT 14",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022154720",
            "telephone_number": "929-434-0651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155491",
            "telephone_number": "929-434-0651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANTA",
        "first_name": "OM BIJU",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-28",
        "last_updated": "2024-12-28",
        "certification_date": "2024-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "3017614",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ameeka Pannu, M.D.
• Prabh Roohan Pannu, MD
• Lucy Panoyan, OD
• Madhavi Pant, M.D
• Pravin Kesari Pant, APRN
• David William Pantalone, PH.D.
• Julia Marie Pantalone, MD
• Sanaya Panthaki
• Lori Ann Panther, M.D., M.P.H.
• Ingrid Pantoja Da Silva Alves, DMD

• Diagnostic Radiology Physician in Boston, MA
• Providers in Boston, MA by specialty
• Diagnostic Radiology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.