Active NPI
Stanley Ip, M.D.
- Pediatrics Physician
- Boston, MA
National Provider Identifier
1659594448
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 55519
- Practice address
- 750 Washington St
Nemc #63
Boston, MA 02111-1526 - Phone
- (617) 636-5241
- NPI assigned
- Apr 10, 2007
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 55519 | MA | Primary |
| Pediatrics Physician | 208000000X | G47881 | CA |
Addresses
Primary practice location
750 Washington St
Nemc #63
Boston, MA 02111-1526
Mailing address
750 Washington St
Nemc #63
Boston, MA 02111-1526
Phone (617) 636-5241
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3082440 | Medicaid | MA |
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G47881 | CA | MD | Pediatrics Physician |
| 55519 | MA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659594448",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "750 WASHINGTON ST",
"address_2": "NEMC #63",
"city": "BOSTON",
"state": "MA",
"postal_code": "021111526",
"telephone_number": "617-636-5241"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 WASHINGTON ST",
"address_2": "NEMC #63",
"city": "BOSTON",
"state": "MA",
"postal_code": "021111526",
"telephone_number": "617-636-5241"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IP",
"first_name": "STANLEY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "55519",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "CA",
"license": "G47881",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3082440",
"state": "MA"
}
],
"endpoints": [],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.