NPIMap

Individual provider Active NPI

Jorge Daniel Oldan

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1649561499
Registry record updated Jul 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
44403 Issued in AZ
Practice address
800 Washington St FL 4
Department of Radiology
Boston, MA 02111-1552
Phone
(480) 301-8000
NPI assigned
Apr 27, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 232461 MA
Diagnostic Radiology Physician 2085R0202X 44403 AZ Primary

Addresses

Primary practice location

800 Washington St FL 4
Department of Radiology
Boston, MA 02111-1552

Mailing address

13400 E Shea Blvd
Scottsdale, AZ 85259-5452

Other identifiers 1

IdentifierTypeStateIssuer
612509MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20151013000429 NC Practitioner - Diagnostic RadiologyPractitioner - Nuclear Medicine 8325226202 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic RadiologyAlso: Nuclear Medicine
Education
State University of New York at Stony Brook, School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 Eastowne Dr
Chapel Hill, NC 27514-2286
Phone (984) 215-5556

101 Manning Dr
Chapel Hill, NC 27514-4220

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44403AZMDDiagnostic Radiology Physician
232461MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Caldwell Memorial Hospital Inc. Diagnostic Radiology CurrentSince Nov 11, 2025 Accepting new patients
University of North Carolina at Chapel Hill CurrentSince Aug 1, 2015 Accepting new patients
Caldwell Memorial Hospital, Inc. CurrentSince Nov 11, 2025 Accepting new patients
Park Ophthalmology Past Accepting new patients
Caldwell Memorial Hospital, Inc Past Accepting new patients

Locations

100 Eastowne Dr
Fl 14
Chapel Hill, NC 27514
Phone (984) 215-5556

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

321 Mulberry St SW
Lenoir, NC 28645
Phone (828) 757-5100

75 Freedom Pkwy
Ste F
Pittsboro, NC 27312
Phone (984) 215-3252

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.

Hospital & facility affiliations 5

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": "1303862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311724800000",
    "number": "1649561499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST FL 4",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "480-301-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLDAN",
        "first_name": "JORGE",
        "middle_name": "DANIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-27",
        "last_updated": "2011-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "232461",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "44403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "612509",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.