Individual provider Active NPI

Ottavio Nardone, M.D.

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1952389892
Registry record updated Jul 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
151255 Issued in MA
Practice address
358 Hanover St
Boston, MA 02113-1302
Phone
(617) 227-5201
Fax
(617) 314-7959
NPI assigned
Jan 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 151255 MA Primary

Addresses

Primary practice location

358 Hanover St
Boston, MA 02113-1302

Mailing address

358 Hanover St
Boston, MA 02113-1302
Phone (617) 227-5201

Other identifiers 1

IdentifierTypeStateIssuer
3159639MedicaidMA

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
I20101109001330 MA Practitioner - Internal Medicine 0547455198 Practice locations: Boston, MA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
151255MAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1136073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277942400000",
    "number": "1952389892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "358 HANOVER ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021131302",
            "telephone_number": "617-227-5201",
            "fax_number": "617-314-7959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "358 HANOVER ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021131302",
            "telephone_number": "617-227-5201",
            "fax_number": "617-314-7959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NARDONE",
        "first_name": "OTTAVIO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-01",
        "last_updated": "2010-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "151255",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3159639",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.