Active NPI
Andrew Li Jen Kung, MD PHD
- Pediatric Hematology & Oncology Physician
- Boston, MA
National Provider Identifier
1720053580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Hematology & Oncology Physician
- License
- 150807
- Practice address
- 44 Binney St
Boston, MA 02115 - Phone
- (617) 632-5731
- Fax
- (617) 582-8096
- NPI assigned
- Feb 22, 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 |
|---|---|---|---|---|
| Pediatric Hematology & Oncology Physician | 2080P0207X | 150807 | MA | Primary |
Addresses
Primary practice location
44 Binney St
Boston, MA 02115
Mailing address
44 Binney St
Mayer 649
Boston, MA 02115
Phone (617) 632-5731
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 47199 | Other | FALLON COMMUNITY HEALTH P | |
| 150807 | Other | TUFTS | |
| 2929488 | Other | AETNA US HEALTHCARE | |
| 900002559 | Other | RR MEDICARE DFCI | |
| 3390960 | Other | CIGNA | |
| J19982 | Other | MASSACHUSETTS BCBS | |
| 14375DF | Other | HPHC DFCI ONLY | |
| 3194191 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 150807 | MA | MD | Pediatric Hematology & Oncology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Hospital Pediatric Associates, Inc | Pediatric Hematology-Oncology | Past | Accepting new patients |
Networks
- Healthfirst Medicare Network H9678
- Healthfirst Medicare Network H1722
- Healthfirst Medicare Network H3359
- Healthfirst Medicare Network H5989
Interoperability endpoints
- akung41670@mskcc.direct-ci.com
Organizations & group practices 2
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.
-
- Pediatrics Physician
- New York, NY
- NPI 1750352381
-
- Pediatrics Physician
- Boston, MA
- NPI 1457306664
Pediatric Hematology-Oncology
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140566400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186963200000",
"number": "1720053580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "44 BINNEY ST",
"address_2": "MAYER 649",
"city": "BOSTON",
"state": "MA",
"postal_code": "02115",
"telephone_number": "617-632-5731",
"fax_number": "617-582-8096"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "44 BINNEY ST",
"city": "BOSTON",
"state": "MA",
"postal_code": "02115",
"telephone_number": "617-632-5731",
"fax_number": "617-582-8096"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KUNG",
"first_name": "ANDREW",
"middle_name": "LI JEN",
"name_prefix": "Dr.",
"credential": "MD PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-22",
"last_updated": "2007-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0207X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Hematology-Oncology",
"state": "MA",
"license": "150807",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FALLON COMMUNITY HEALTH P",
"identifier": "47199",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "150807",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA US HEALTHCARE",
"identifier": "2929488",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE DFCI",
"identifier": "900002559",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "3390960",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MASSACHUSETTS BCBS",
"identifier": "J19982",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HPHC DFCI ONLY",
"identifier": "14375DF",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3194191",
"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 Aug 13, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.