Active NPI
Nicoletta A Fynn-Thompson, MD
- Ophthalmology Physician
- Boston, MA
National Provider Identifier
1609859057
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Ophthalmology Physician
- License
- 216971
- Practice address
- 50 Staniford St
Suite 600
Boston, MA 02114-2517 - Phone
- (617) 367-4800
- Fax
- (617) 723-7028
- NPI assigned
- Nov 21, 2005
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Ophthalmology Physician | 207W00000X | 216971 | MA | Primary |
Addresses
Primary practice location
50 Staniford St
Suite 600
Boston, MA 02114-2517
Mailing address
50 Staniford St
Suite 600
Boston, MA 02114-2517
Phone (617) 367-4800
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 471664 | Other | MA | TUFTS HEALTH PLAN |
| J26384 | Other | MA | BCBS MA |
| 2078341 | Medicaid | MA | |
| 110038924A | Medicaid | MA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | fynn-thompson.nicoletta.ocb@direct.partners.masshiway.net | Health Information Exchange (HIE) |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 216971 | MA | MD | Ophthalmology Physician |
Interoperability endpoints
- fynn-thompson.nicoletta.ocb@direct.partners.masshiway.net
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132531200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1640044800000",
"number": "1609859057",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "50 STANIFORD ST",
"address_2": "SUITE 600",
"city": "BOSTON",
"state": "MA",
"postal_code": "021142517",
"telephone_number": "617-367-4800",
"fax_number": "617-723-7028"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 STANIFORD ST",
"address_2": "SUITE 600",
"city": "BOSTON",
"state": "MA",
"postal_code": "021142517",
"telephone_number": "617-367-4800",
"fax_number": "617-723-7028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FYNN-THOMPSON",
"first_name": "NICOLETTA",
"middle_name": "A",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-21",
"last_updated": "2021-12-21",
"certification_date": "2021-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "207W00000X",
"taxonomy_group": "",
"desc": "Ophthalmology",
"state": "MA",
"license": "216971",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH PLAN",
"identifier": "471664",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS MA",
"identifier": "J26384",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2078341",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110038924A",
"state": "MA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "fynn-thompson.nicoletta.ocb@direct.partners.masshiway.net",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"address_1": "50 Staniford St",
"address_2": "Suite 600",
"city": "Boston",
"state": "MA",
"country_code": "US",
"postal_code": "021142517",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Dec 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.