Individual provider Active NPI

Gena Heidary, MD

  • Ophthalmology Physician
  • Boston, MA
National Provider Identifier
1972651206
Registry record updated Feb 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
224710 Issued in MA
Practice address
300 Longwood Ave # Fegan4
Department of Ophthalmology Children'S Hospital Boston
Boston, MA 02115-5724
Phone
(617) 355-6401
NPI assigned
Jan 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology Physician 207W00000X 224710 MA Primary

Addresses

Primary practice location

300 Longwood Ave # Fegan4
Department of Ophthalmology Children'S Hospital Boston
Boston, MA 02115-5724

Mailing address

300 Longwood Ave # Fegan4
Department of Ophthalmology Children'S Hospital Boston
Boston, MA 02115-5724
Phone (617) 355-6401

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
I20090414000697 MA Practitioner - Ophthalmology 8628125358 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Ophthalmology
Education
Perelman School of Med at the University of Pennsylvania, 2004
Medicare assignment
May accept Medicare assignment
Group practices
Childrens Hospital Ophthalmology Foundation IncGroup PAC ID 8729049150, 26 clinicians

Practice addresses (Care Compare)

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

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
224710MAMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Hospital Ophthalmology Foundation Inc Ophthalmology CurrentSince Mar 25, 2009 Accepting new patients
Children'S Hospital Pediatric Associates, Inc Past Accepting new patients

Locations

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

300 Longwood Ave
#4
Boston, MA 02115
Phone (617) 355-6401

Interoperability endpoints

  • Direct secure messaging: gheidary26783@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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234137600000",
    "number": "1972651206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE # FEGAN4",
            "address_2": "DEPARTMENT OF OPHTHALMOLOGY CHILDREN'S HOSPITAL BOSTON",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-6401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE # FEGAN4",
            "address_2": "DEPARTMENT OF OPHTHALMOLOGY CHILDREN'S HOSPITAL BOSTON",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-6401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEIDARY",
        "first_name": "GENA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2009-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "224710",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.