Active NPI
Nhan Van DO, MD
- Internal Medicine Physician
- Boston, MA
National Provider Identifier
1750353967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 0101259524
- Practice address
- 150 S Huntington Ave
Boston, MA 02130-4817 - Phone
- (617) 390-6771
- NPI assigned
- Feb 2, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 0101259524 | VA | Primary |
Addresses
Primary practice location
150 S Huntington Ave
Boston, MA 02130-4817
Mailing address
43 Bonad Rd
West Roxbury, MA 02132-1135
Phone (703) 835-3843
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170405001985 | MA | Order and Referring Only - Internal Medicine | 4587940598 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0101259524 | VA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649980800000",
"number": "1750353967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "43 BONAD RD",
"city": "WEST ROXBURY",
"state": "MA",
"postal_code": "021321135",
"telephone_number": "703-835-3843"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 S HUNTINGTON AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021304817",
"telephone_number": "617-390-6771"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DO",
"first_name": "NHAN",
"middle_name": "VAN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-02-02",
"last_updated": "2022-04-15",
"certification_date": "2022-04-15",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "VA",
"license": "0101259524",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2022; 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.