Active NPI
Dongchan Park, M.D
- Psychiatry Physician
- Boston, MA
National Provider Identifier
1831458678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 1831458678
- Practice address
- 850 Harrison Ave
Boston, MA 02118-4001 - Phone
- (617) 638-8540
- Fax
- (617) 638-8542
- NPI assigned
- May 14, 2012
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 1831458678 | MA | Primary |
Addresses
Primary practice location
850 Harrison Ave
Boston, MA 02118-4001
Mailing address
850 Harrison Ave
Dowling 7S
Boston, MA 02118-4001
Phone (617) 638-8540
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1831458678 | MA | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Rethink Minds LLC | Psychiatry | Current | Accepting new patients |
| Bournewood Clinical Associates | Psychiatry | Current | Accepting new patients |
Locations
300 South St
Chestnut Hill, MA 02467
Phone (617) 469-0300
Organizations & group practices 2
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.
-
- Psychiatry Physician
- Cambridge, MA
- NPI 1457058422
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1336953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1356739200000",
"number": "1831458678",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 HARRISON AVE",
"address_2": "DOWLING 7S",
"city": "BOSTON",
"state": "MA",
"postal_code": "021184001",
"telephone_number": "617-638-8540",
"fax_number": "617-638-8542"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "850 HARRISON AVE",
"city": "BOSTON",
"state": "MA",
"postal_code": "021184001",
"telephone_number": "617-638-8540",
"fax_number": "617-638-8542"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PARK",
"first_name": "DONGCHAN",
"credential": "M.D",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-05-14",
"last_updated": "2012-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "1831458678",
"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 Dec 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.