Organization Active NPI

Michael J Yaremchuk, M.D., PC

  • Plastic and Reconstructive Surgery Physician
  • Boston, MA
National Provider Identifier
1710129119
Registry record updated Jul 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic and Reconstructive Surgery PhysicianTaxonomy code 2086S0122X
License
41996 Issued in MA
Legal business name
MICHAEL J YAREMCHUK, M.D., PC
Practice address
15 Parkman St
MGH Wacc Suite 435
Boston, MA 02114-3117
Phone
(978) 535-6043
Fax
(978) 535-6047
NPI assigned
Mar 31, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2009

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

Authorized official

Name
Ann Marie McGrane
Title
Billing Coordinator
Phone
(978) 535-6043

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic and Reconstructive Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0122X 41996 MA Primary

Addresses

Primary practice location

15 Parkman St
MGH Wacc Suite 435
Boston, MA 02114-3117

Mailing address

15 Parkman St
MGH Wacc Suite 435
Boston, MA 02114-3117
Phone (978) 535-6043

Other identifiers 1

IdentifierTypeStateIssuer
3029662MedicaidMA

National Provider Directory

National Provider Directory

Locations

15 Parkman St
Ste 435
Boston, MA 02114

170 Commonwealth Ave
Boston, MA 02116
Phone (617) 267-0710

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1238457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248220800000",
    "number": "1710129119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 PARKMAN ST",
            "address_2": "MGH WACC SUITE 435",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021143117",
            "telephone_number": "978-535-6043",
            "fax_number": "978-535-6047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 PARKMAN ST",
            "address_2": "MGH WACC SUITE 435",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021143117",
            "telephone_number": "978-535-6043",
            "fax_number": "978-535-6047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J YAREMCHUK, M.D., PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-31",
        "last_updated": "2009-07-22",
        "status": "A",
        "authorized_official_last_name": "MCGRANE",
        "authorized_official_first_name": "ANN MARIE",
        "authorized_official_title_or_position": "BILLING COORDINATOR",
        "authorized_official_telephone_number": "978-535-6043"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MA",
            "license": "41996",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3029662",
            "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 22, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.