Individual provider Active NPI

Amy W Conrad, M.D.

  • Pediatrics Physician
  • Cambridge, MA
National Provider Identifier
1922493774
Registry record updated Sep 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
277391 Issued in MA
Practice address
575 Mount Auburn St Ste 202
Cambridge, MA 02138-4627
Phone
(617) 864-7071
NPI assigned
Mar 30, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 277391 MA Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

575 Mount Auburn St Ste 202
Cambridge, MA 02138-4627

Mailing address

575 Mount Auburn St Ste 202
Cambridge, MA 02138-4627
Phone (617) 864-7071

Other practice location 1

3800 Reservoir Rd NW
Department of Pediatrics
Washington, DC 20007-2113
Phone (202) 243-3434

Other names 1

  • Amy Fan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20250925000361 IL Practitioner - Pediatric Medicine 6305181645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
University of Virginia School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

611 W Park St
Fapc
Urbana, IL 61859-2500

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Carle Health Care Incorporated CurrentSince Sep 15, 2025 Accepting new patients
Carle Health Care Incorporated Past Accepting new patients

Locations

1701 Curtis Rd
Champaign, IL 61822
Phone (217) 365-6201

611 W Park St
Urbana, IL 61801
Phone (217) 383-6941

1818 E Windsor Rd
Urbana, IL 61802
Phone (217) 255-9646

Interoperability endpoints

  • Direct secure messaging: aconradmd458927@carlehiedirect.net

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": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757376000000",
    "number": "1922493774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 MOUNT AUBURN ST STE 202",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384627",
            "telephone_number": "617-864-7071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 MOUNT AUBURN ST STE 202",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384627",
            "telephone_number": "617-864-7071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3800 Reservoir Rd NW",
            "address_2": "Department of Pediatrics",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200072113",
            "country_code": "US",
            "telephone_number": "202-243-3434",
            "fax_number": "202-243-3234",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONRAD",
        "first_name": "AMY",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-30",
        "last_updated": "2025-09-09",
        "certification_date": "2025-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "277391",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "FAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.