Individual provider Active NPI

Tobias Loddenkemper, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Boston, MA
National Provider Identifier
1922272350
Registry record updated Sep 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
57.006941 Issued in OH
Practice address
300 Longwood Ave
Fegan 9
Boston, MA 02115-5724
Phone
(617) 355-6000
NPI assigned
Apr 16, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2008

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 57.006941 OH
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 57.006941 OH Primary
Clinical Neurophysiology Physician 2084N0600X 57.006941 OH

Addresses

Primary practice location

300 Longwood Ave
Fegan 9
Boston, MA 02115-5724

Mailing address

300 Longwood Ave
Fegan 9
Boston, MA 02115-5724
Phone (617) 355-6000

Other identifiers 1

IdentifierTypeStateIssuer
2155958MedicaidMA

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
I20090922000565 MA Practitioner - Neurology 7618023326 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
C H Neurology Foundation IncGroup PAC ID 5496744195, 56 clinicians

Practice addresses (Care Compare)

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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57.006941OHMDClinical Neurophysiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
C H Neurology Foundation Inc Pediatrics CurrentSince Aug 12, 2009 Accepting new patients
Childrens Hospital Boston Past Accepting new patients

Locations

300 Longwood Ave
Ofc
Boston, MA 02115
Phone (617) 355-8083

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

300 Longwood Ave
#9
Boston, MA 02115
Phone (617) 355-2413

Interoperability endpoints

  • Direct secure messaging: tloddenkemper66132@direct.bostonchildrens.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1208304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221177600000",
    "number": "1922272350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "address_2": "FEGAN 9",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "address_2": "FEGAN 9",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LODDENKEMPER",
        "first_name": "TOBIAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-04-16",
        "last_updated": "2008-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "57.006941",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "OH",
            "license": "57.006941",
            "primary": true
        },
        {
            "code": "2084N0600X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Clinical Neurophysiology",
            "state": "OH",
            "license": "57.006941",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2155958",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.