Individual provider Active NPI

Tanya Ianniello, M.D.

  • Pediatrics Physician
  • Boston, MA
National Provider Identifier
1740347301
Registry record updated Jun 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
238350 Issued in MA
Practice address
55 Fruit St
Boston, MA 02114-2621
Phone
(617) 724-9040
NPI assigned
Jan 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2019

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 238350 MA Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2621

Mailing address

7 Beethoven Ave
Waban, MA 02468-1732

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
I20130124000098 MA Practitioner - Pediatric Medicine 9436302502 Reassigns benefits to 5 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts General Physicians Organization Inc Pediatrics CurrentSince Aug 1, 2019 Accepting new patients
BMC Affiliated Physicians, Inc. CurrentSince Apr 1, 2025 Accepting new patients
The General Hospital Corporation CurrentSince Aug 1, 2019 Accepting new patients
Steward Medical Group, Inc CurrentSince Oct 30, 2023 Accepting new patients
Steward Medical Group, Inc CurrentSince Oct 30, 2023 Accepting new patients
General Hospital Corp Current Accepting new patients

Locations

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

55 Fruit St
Boston, MA 02114

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

235 N Pearl St
Brockton, MA 02301
Phone (508) 427-2525

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

70 East St
Methuen, MA 01844
Phone (978) 682-1906

Interoperability endpoints

  • Direct secure messaging: ianniello.tanya.mgh@direct.partners.masshiway.net

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1559520000000",
    "number": "1740347301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 BEETHOVEN AVE",
            "city": "WABAN",
            "state": "MA",
            "postal_code": "024681732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-724-9040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IANNIELLO",
        "first_name": "TANYA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-03",
        "last_updated": "2019-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "238350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.