Individual provider Active NPI

Michael J. Cunningham, M.D.

  • Pediatric Otolaryngology Physician
  • Boston, MA
National Provider Identifier
1811988181
Registry record updated Aug 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Otolaryngology PhysicianTaxonomy code 207YP0228X
License
58974 Issued in MA
Practice address
243 Charles St
Boston, MA 02114-3002
Phone
(617) 573-4458
NPI assigned
Nov 4, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Otolaryngology Physician 207YP0228X 58974 MA Primary

Addresses

Primary practice location

243 Charles St
Boston, MA 02114-3002

Mailing address

243 Charles St
Boston, MA 02114-3002
Phone (617) 573-4458

Other identifiers 1

IdentifierTypeStateIssuer
3019748MedicaidMA

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
I20110104000088 MA Practitioner - Otolaryngology 5193913374 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58974MAMDPediatric Otolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CHMC Otolaryngologic Foundation, Inc Pediatric Otolaryngology CurrentSince Dec 1, 2010 Accepting new patients

Locations

300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956

300 Longwood Ave
#367
Boston, MA 02115
Phone (617) 355-6417

Interoperability endpoints

  • Direct secure messaging: mcunningham27177@direct.bostonchildrens.org

Organizations & group practices 1

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": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280880000000",
    "number": "1811988181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "243 CHARLES ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021143002",
            "telephone_number": "617-573-4458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "243 CHARLES ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021143002",
            "telephone_number": "617-573-4458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-04",
        "last_updated": "2010-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YP0228X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Pediatric Otolaryngology",
            "state": "MA",
            "license": "58974",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3019748",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.