Individual provider Active NPI

Samantha Parad

  • General Practice Dentistry
  • Boston, MA
National Provider Identifier
1740865641
Registry record updated Dec 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN1859118 Issued in MA
Practice address
1 Kneeland St FL 3
Boston, MA 02111-1527
Phone
(617) 636-6878
NPI assigned
Mar 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN1859118 MA Primary

Addresses

Primary practice location

1 Kneeland St FL 3
Boston, MA 02111-1527

Mailing address

1 Kneeland St RM 319
Boston, MA 02111-1527
Phone (617) 636-3489

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250207001381 MA Practitioner - Dentist 7416487350 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Cambridge Public Health Commission CurrentSince Jan 10, 2025 Accepting new patients
Cambridge Public Health Commission Current Accepting new patients
Massachusetts General Physicians Organization PastSince Mar 1, 2021 Accepting new patients

Locations

1493 Cambridge St
Cambridge, MA 02139
Phone (617) 665-1185

119 Windsor St
Cambridge, MA 02139
Phone (617) 665-3600

103 Garland St
Everett, MA 02149
Phone (617) 381-7150

Interoperability endpoints

  • Direct secure messaging: sparad122579@direct.challiance.masshiway.net
  • Direct secure messaging: sparad189984@direct.bostonchildrens.org

Organizations & group practices 3

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": "1615420800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702425600000",
    "number": "1740865641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KNEELAND ST RM 319",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111527",
            "telephone_number": "617-636-3489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KNEELAND ST FL 3",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111527",
            "telephone_number": "617-636-6878"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARAD",
        "first_name": "SAMANTHA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-11",
        "last_updated": "2023-12-13",
        "certification_date": "2023-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1859118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.