Active NPI
John Fiadjoe, M.D.
- Pediatric Anesthesiology Physician
- Boston, MA
National Provider Identifier
1881701464
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Anesthesiology Physician
- License
- 286278
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 183049EJL | Other | PA | MEDICARE PTAN |
| 1016180790 | Medicaid | PA |
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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 286278 | MA | MD | Pediatric Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| CHMC Anesthesia Foundation Inc | Anesthesiology | Current | 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
- 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.
-
- Pediatric Anesthesiology Physician
- Philadelphia, PA
- NPI 1689779480
-
- Pediatric Anesthesiology Physician
- Boston, MA
- NPI 1831268754
-
- Anesthesiology Physician
- Brooklyn, NY
- NPI 1104878180
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2021; 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.