Steven R Kanner, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

36451 Issued in MA

Practice address

210 Bear Hill Rd
Suite 304
Waltham, MA 02451-1025

Phone

(781) 684-0600

Fax

(781) 684-0601

NPI assigned

Oct 26, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Discover Health Medical Group Three, Inc.

  • Internal Medicine Physician
  • Waltham, MA
  • NPI 1710601661
  Medicare reassignment NPD
• SRK MD, LLC

  • Internal Medicine Physician
  • Waltham, MA
  • NPI 1578083119
  NPD Authorized official

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

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1252972800000",
    "number": "1740270289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 BYPASS RD",
            "address_2": "LINCOLN",
            "city": "LINCOLN",
            "state": "MA",
            "postal_code": "017731202",
            "telephone_number": "781-259-3370",
            "fax_number": "781-259-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 BEAR HILL RD",
            "address_2": "SUITE 304",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024511025",
            "telephone_number": "781-684-0600",
            "fax_number": "781-684-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANNER",
        "first_name": "STEVEN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-26",
        "last_updated": "2009-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "36451",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "B49032",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "706384",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2066513",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angella Kamikazi
• Christina Sonya Kammel, D,P,T,
• Betsy L Kammerer, PHD
• Beatrice Kamya, RNP
• Karla B Kanis, M.D.
• Rebecca J Kano, MD
• Rachel Margaret Kantor, PSYD
• Brooke Kapetanakos
• Aaron Kaplan, PSYD
• Alison Kaplanes, MS, RD, LDN, CDE

• Internal Medicine Physician in Waltham, MA
• Providers in Waltham, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2009; 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.

Verify at the official NPI Registry.