Individual provider Active NPI

Tiffany K Johnson, MD

  • Pediatrics Physician
  • Boston, MA
National Provider Identifier
1730617911
Registry record updated May 31, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
271983 Issued in MA
Practice address
800 Washington St # 286
Boston, MA 02111-1552
Phone
(617) 636-5078
Fax
(617) 636-8391
NPI assigned
May 31, 2017
Last updated
May 31, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 31, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 271983 MA Primary

Addresses

Primary practice location

800 Washington St # 286
Boston, MA 02111-1552

Mailing address

PO Box 958
Salem, NH 03079-0958
Phone (978) 476-6886

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20230214001171 MA Practitioner - Pediatric Medicine 2365715455 Reassigns benefits to 1 organization
I20230214001545 NH Practitioner - Pediatric Medicine 2365715455 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

19 Main St
FL 1
Salem, NH 03079-1988
Phone (978) 683-4299

555 Turnpike St
Suite 31
North Andover, MA 01845-5935
Phone (978) 655-7820

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
New England Allergy,Asthma,Immunology,Pediatric and Primary Care, PLLC Pediatrics CurrentSince Jan 1, 2023 Accepting new patients
Tufts Medical Center Past Accepting new patients

Locations

555 Turnpike St
North Andover, MA 01845
Phone (508) 683-4299

555 Turnpike St
Ste 31
North Andover, MA 01845
Phone (978) 683-4299

Interoperability endpoints

  • Direct secure messaging: tiffanyjohnson@neaaipp.allscriptsdirect.net

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, 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": "1496188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1496188800000",
    "number": "1730617911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 958",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030790958",
            "telephone_number": "978-476-6886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST # 286",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-5078",
            "fax_number": "617-636-8391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TIFFANY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-31",
        "last_updated": "2017-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "271983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.