Individual provider Active NPI

Andrew C Ahn, M.D.

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1730291402
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
206819 Issued in MA
Practice address
401 Park Dr
Suite 22a West
Boston, MA 02215-3325
Phone
(617) 384-8581
NPI assigned
Aug 31, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 206819 MA Primary

Addresses

Primary practice location

401 Park Dr
Suite 22a West
Boston, MA 02215-3325

Mailing address

47 Barbara Rd
Needham, MA 02492-4401
Phone (617) 384-8581

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041116001072 MA Practitioner - Internal Medicine 4688638976 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
206819MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Internal Medicine CurrentSince May 23, 2008 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince May 23, 2008 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is Internal Medicine CurrentSince Jan 1, 2015 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Jan 24, 2011 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Jan 24, 2011 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is CurrentSince Jan 1, 2015 Accepting new patients
Emerson Hospital Past Accepting new patients

Locations

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

199 Reedsdale Rd
Milton, MA 02186
Phone (617) 313-1000

275 Sandwich St
Plymouth, MA 02360
Phone (508) 746-2000

46 Obery St
Plymouth, MA 02360
Phone (508) 210-5920

93 Pond St
Sharon, MA 02067
Phone (781) 784-9212

1 University Ave
Westwood, MA 02090
Phone (617) 754-1021

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730291402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 BARBARA RD",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024924401",
            "telephone_number": "617-384-8581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 PARK DR",
            "address_2": "SUITE 22A WEST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022153325",
            "telephone_number": "617-384-8581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHN",
        "first_name": "ANDREW",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "206819",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.