Individual provider Active NPI

Pratheeban Nambyiah, MD

  • Pediatric Anesthesiology Physician
  • Boston, MA
National Provider Identifier
1952148306
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Anesthesiology PhysicianTaxonomy code 207LP3000X
License
5001484 Issued in MA
Practice address
300 Longwood Ave
Boston, MA 02115-5724
Phone
(617) 355-6000
NPI assigned
Jul 12, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Anesthesiology Physician 207LP3000X 5001484 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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

NPI Registry JSON

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

{
    "created_epoch": "1720742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1952148306",
    "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"
        },
        {
            "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"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAMBYIAH",
        "first_name": "PRATHEEBAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-12",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207LP3000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pediatric Anesthesiology",
            "state": "MA",
            "license": "5001484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.