Active NPI
Robert Chernack, MD
- Sports Medicine (Neuromusculoskeletal Medicine) Physician
- Somerville, MA
National Provider Identifier
1700941143
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Medicine (Neuromusculoskeletal Medicine) Physician
- License
- 52333
- Practice address
- 40 Holland St
Somerville, MA 02144-2705 - Phone
- (617) 629-6220
- Fax
- (617) 629-6248
- NPI assigned
- Dec 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 |
|---|---|---|---|---|
| Sports Medicine (Neuromusculoskeletal Medicine) Physician | 204C00000X | 52333 | MA | Primary |
Addresses
Primary practice location
40 Holland St
Somerville, MA 02144-2705
Mailing address
147 Milk St
Boston, MA 02109-4806
Other identifiers 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3178854 | Medicaid | MA | |
| 0014437 | Other | MA | NHP |
| 6239385-002 | Other | MA | CIGNA |
| 052333 | Other | MA | TUFTS |
| J11781 | Other | MA | BCBS |
| PB222 | Other | MA | HPHC |
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 |
|---|---|---|---|
| 52333 | MA | MD | Sports Medicine (Neuromusculoskeletal Medicine) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307491200000",
"number": "1700941143",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147 MILK ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "021094806"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 HOLLAND ST",
"city": "SOMERVILLE",
"state": "MA",
"postal_code": "021442705",
"telephone_number": "617-629-6220",
"fax_number": "617-629-6248"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHERNACK",
"first_name": "ROBERT",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-26",
"last_updated": "2011-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "204C00000X",
"taxonomy_group": "",
"desc": "Neuromusculoskeletal Medicine, Sports Medicine",
"state": "MA",
"license": "52333",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3178854",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NHP",
"identifier": "0014437",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "6239385-002",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "052333",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "J11781",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HPHC",
"identifier": "PB222",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Somerville, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 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.