Active NPI
Ira N Kirschenbaum, M.D.
- Diagnostic Radiology Physician
- Medford, MA
National Provider Identifier
1659337657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 30357
- Practice address
- 26 City Hall Mall
Medford, MA 02155-4754 - Phone
- (781) 306-5100
- Fax
- (781) 306-5379
- NPI assigned
- Apr 26, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 30357 | MA | Primary |
Addresses
Primary practice location
26 City Hall Mall
Medford, MA 02155-4754
Mailing address
147 Milk St
Provider Enrollment Department - 9TH Floor
Boston, MA 02109-4806
Phone (617) 421-2508
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6031309-001 | Other | MA | CIGNA |
| 0146749 | Medicaid | MA | |
| 030357 | Other | MD | TUFTS HEALTH PLAN |
| 0017155 | Other | MA | NEIGHBORHOOD HEALTH |
| C04608 | Other | MA | BLUE CROSS BLUE SHIELD |
| 300126057 | Other | MA | RAILROAD |
| 6031309-001 | Other | MD | HEALTHSOURCE |
| R121 | Other | MA | HARVARD PILGRIM |
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 |
|---|---|---|---|
| 30357 | MA | MD | Diagnostic Radiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146009600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1305158400000",
"number": "1659337657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147 MILK ST",
"address_2": "PROVIDER ENROLLMENT DEPARTMENT - 9TH FLOOR",
"city": "BOSTON",
"state": "MA",
"postal_code": "021094806",
"telephone_number": "617-421-2508",
"fax_number": "617-421-3487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "26 CITY HALL MALL",
"city": "MEDFORD",
"state": "MA",
"postal_code": "021554754",
"telephone_number": "781-306-5100",
"fax_number": "781-306-5379"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIRSCHENBAUM",
"first_name": "IRA",
"middle_name": "N",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-26",
"last_updated": "2011-05-12",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MA",
"license": "30357",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "6031309-001",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0146749",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH PLAN",
"identifier": "030357",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBORHOOD HEALTH",
"identifier": "0017155",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "C04608",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD",
"identifier": "300126057",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHSOURCE",
"identifier": "6031309-001",
"state": "MD"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "R121",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Medford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.