NPIMap

Individual provider Active NPI

Peter Siao-Tick-Chong, MD

  • Neurology Physician
  • Boston, MA
National Provider Identifier
1548238967
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
60457 Issued in MA
Practice address
725 Albany Street, Suite 7B
Shapiro BLDG
Boston, MA 02118-3549
Phone
(617) 638-8456
Fax
(617) 638-8465
NPI assigned
Mar 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neurophysiology Physician 2084N0600X 60457 MA
Neurology Physician 2084N0400X 60457 MA Primary
Neuromuscular Medicine (Psychiatry & Neurology) Physician 2084N0008X 60457 MA

Addresses

Primary practice location

725 Albany Street, Suite 7B
Shapiro BLDG
Boston, MA 02118-3549

Mailing address

960 Massachusetts Ave, FL 2
Boston, MA 02118-2690

Other identifiers 2

IdentifierTypeStateIssuer
3117373MedicaidNH
110060456AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040518000737 MA Practitioner - Neurology 7719977982 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Boston University Neurology Associates IncGroup PAC ID 6608772462, 60 clinicians

Practice addresses (Care Compare)

1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (617) 638-8456

725 Albany St
Suite 7B
Boston, MA 02118-3549
Phone (617) 638-8456

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
60457MAMDNeuromuscular Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boston University Neurology Associates, Inc. Neurology CurrentSince Apr 1, 2011 Accepting new patients
Boston Medical Center Corporation Current Accepting new patients

Locations

960 Massachusetts Ave
Ste 2
Boston, MA 02118

725 Albany St
Ste 7
Boston, MA 02118
Phone (617) 638-8456

725 Albany St
Ste B
Boston, MA 02118
Phone (617) 638-7480

725 Albany St
Ste 7B
Boston, MA 02118
Phone (617) 638-7490

720 Harrison Ave
#503
Roxbury, MA 02118
Phone 6174145404 ext. 2

Interoperability endpoints

  • Direct secure messaging: psiaotickchong12077@direct.bmc.masshiway.net

Organizations & group practices 2

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 8

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": "1141948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1548238967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVE, FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 ALBANY STREET, SUITE 7B",
            "address_2": "SHAPIRO BLDG",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021183549",
            "telephone_number": "617-638-8456",
            "fax_number": "617-638-8465"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIAO-TICK-CHONG",
        "first_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-10",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "MA",
            "license": "60457",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MA",
            "license": "60457",
            "primary": true
        },
        {
            "code": "2084N0008X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neuromuscular Medicine",
            "state": "MA",
            "license": "60457",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3117373",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110060456A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.