Individual provider Active NPI

Maryellen Sun, M.D.

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1861661092
Registry record updated Aug 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
234487 Issued in MA
Practice address
Beth Israel Deaconess Medical Center
330 Brookline Avenue
Boston, MA 02215
Phone
(617) 754-2521
NPI assigned
Feb 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 234487 MA Primary

Addresses

Primary practice location

Beth Israel Deaconess Medical Center
330 Brookline Avenue
Boston, MA 02215

Mailing address

83 Lee St
Brookline, MA 02445-5912
Phone (617) 487-5215

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20080826000376 MA Practitioner - Diagnostic Radiology 4082789011 Reassigns benefits to 5 organizations
I20220610001193 RI Practitioner - Diagnostic Radiology 4082789011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Harvard Medical School, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Schatzki Associates IncGroup PAC ID 4789653825, 19 clinicians

Practice addresses (Care Compare)

22 Mill St
Arlington, MA 02476-4784
Phone (617) 492-3500

259 Forge Rd
North Kingstown, RI 02852-1009
Phone (617) 499-5070

Hospital & facility affiliations

  • Mount Auburn Hospital Hospital, Cambridge, MA, CCN 220002

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
234487MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts Institute of Technology CurrentSince Sep 23, 2021 Accepting new patients
Merrimack Radiology-Cra LLC Diagnostic Radiology CurrentSince Jan 1, 2017 Accepting new patients
Mass General Brigham Community Physicians Inc CurrentSince Jan 2, 2017 Accepting new patients
President & Fellows of Harvard College CurrentSince Dec 14, 2021 Accepting new patients
President and Fellows of Harvard College CurrentSince Dec 14, 2021 Accepting new patients
Schatzki Associates Inc. Diagnostic Radiology CurrentSince Nov 15, 2021 Accepting new patients
Mass General Brigham Community Physicians Inc. CurrentSince Jan 2, 2017 Accepting new patients
MW Radiology-Cra LLC Diagnostic Radiology PastSince Apr 5, 2020 Accepting new patients
Meyer Physical Therapy Past Accepting new patients

Locations

22 Mill St
Arlington, MA 02476
Phone (781) 646-8440

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

188 Longwood Ave
Boston, MA 02115
Phone (617) 432-1434

25 Carleton St
Cambridge, MA 02142
Phone (617) 253-0556

75 Mount Auburn St
#H
Cambridge, MA 02138
Phone (617) 495-4414

75 Mount Auburn St
Cambridge, MA 02138
Phone (617) 495-2042

330 Mount Auburn St
Cambridge, MA 02138
Phone (617) 499-5054

102 Endicott St
Danvers, MA 01923
Phone (978) 882-6100

1 Parkway
Haverhill, MA 01830
Phone (978) 521-3210

500 Merrimack St
Lawrence, MA 01843
Phone (978) 557-8800

295 Varnum Ave
Lowell, MA 01854
Phone (978) 788-7344

170 Governors Ave
Medford, MA 02155
Phone (781) 306-6000

81 Highland Ave
Salem, MA 01970
Phone (978) 354-4009

Interoperability endpoints

  • Direct secure messaging: msun519563@direct.bilh.masshiway.net

Organizations & group practices 9

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1203552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312243200000",
    "number": "1861661092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 LEE ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024455912",
            "telephone_number": "617-487-5215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BETH ISRAEL DEACONESS MEDICAL CENTER",
            "address_2": "330 BROOKLINE AVENUE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02215",
            "telephone_number": "617-754-2521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUN",
        "first_name": "MARYELLEN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-21",
        "last_updated": "2011-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "234487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.