Individual provider Active NPI

John Fiadjoe, M.D.

  • Pediatric Anesthesiology Physician
  • Boston, MA
National Provider Identifier
1881701464
Registry record updated Apr 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
286278 Issued in MA
Practice address
300 Longwood Ave
Boston, MA 02115-5724
Phone
(617) 355-6000
Fax
(267) 425-9331
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X MD423799 PA
Pediatric Anesthesiology Physician 207LP3000X MD423799 PA
Pediatric Anesthesiology Physician 207LP3000X 286278 MA Primary

Addresses

Primary practice location

300 Longwood Ave
Boston, MA 02115-5724

Mailing address

300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-6000

Other practice location 1

34th Street & Civic Center Blvd
Suite 9329
Philadelphia, PA 19104-4399
Phone (215) 590-1858

Other identifiers 2

IdentifierTypeStateIssuer
183049EJLOtherPAMEDICARE PTAN
1016180790MedicaidPA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20070413000282 PA Practitioner - Anesthesiology 0840251922 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
286278MAMDPediatric Anesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
CHMC Anesthesia Foundation Inc Anesthesiology CurrentSince Apr 1, 2021 Accepting new patients
University Physicians of Brooklyn, Inc Anesthesiology Past Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: jfiadjoe23337@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": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617926400000",
    "number": "1881701464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-6000",
            "fax_number": "267-425-9331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-6000",
            "fax_number": "267-425-9331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "34th Street & Civic Center Blvd",
            "address_2": "Suite 9329",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191044399",
            "country_code": "US",
            "telephone_number": "215-590-1858",
            "fax_number": "215-590-1415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FIADJOE",
        "first_name": "JOHN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2021-04-09",
        "certification_date": "2021-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MD423799",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "PA",
            "license": "MD423799",
            "primary": false
        },
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "MA",
            "license": "286278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "183049EJL",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1016180790",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.