DR. JOSEPH PHILIP VACANTI (NPI# 1396736906) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1396736906 |
Entity Type | Individual |
Full Name | DR. JOSEPH PHILIP VACANTI |
Credential | MD |
Practice Address |
55 Fruit St Wrn 1157 Boston MA 02114-2621 |
Mailing Address |
Po Box 9142 Mass General Physician Organization Charlestown MA 02129-9142 |
Practice Telephone | 6177241725 |
Practice Fax Number | 6177267593 |
Mailing Telephone | 6177241725 |
Mailing Fax Number | 6177267593 |
Enumeration Date | 2005-11-02 |
Last Update Date | 2013-01-03 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
39234 | MA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MA | BCBS MA | C05171 | 01 |
MA | 2055481 | 05 | |
MA | TUFTS HEALTH PLAN | 702960 | 01 |
Street Address |
55 FRUIT ST WRN 1157 |
City | BOSTON |
State | MA |
Zip Code | 02114-2621 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1568465888 | Michael A Nichols | Nurse Anesthetist, Certified Registered | 55 Fruit St, Boston, MA 02114-2696 | 2005-05-31 |
1740881374 | Katelyn Mary Bushey | Clinical Nurse Specialist | 55 Fruit St, Boston, MA 02114-2696 | 2020-11-02 |
1316546849 | Amy Lauren Greenblatt | Student in an Organized Health Care Education/Training Program | 55 Fruit St, Boston, MA 02114-2696 | 2020-10-26 |
1134728116 | Stephanie Qualls | Student in an Organized Health Care Education/Training Program | 55 Fruit St, Boston, MA 02114-2621 | 2020-10-21 |
1811596190 | Andrea S Hansen | Clinical Nurse Specialist | 55 Fruit St, Boston, MA 02114-2696 | 2020-10-19 |
1649879974 | Barbara Healy | Nurse Practitioner | 55 Fruit St, Boston, MA 02114-2696 | 2020-10-19 |
1770181117 | Molly Cristina Reynolds | Nurse Practitioner | 55 Fruit St, Boston, MA 02114-2621 | 2020-10-16 |
1245838325 | Katerina Eleni Kafkas | Nurse Practitioner | 55 Fruit St, Boston, MA 02114-2621 | 2020-10-12 |
1578179040 | Vivian Ellen Donahue | Registered Nurse | 55 Fruit St, Boston, MA 02114-2696 | 2020-09-21 |
1699380956 | Joanne Gover | Registered Nurse | 55 Fruit St, Boston, MA 02114-2621 | 2020-09-14 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1588276281 | Guoliang Qiao | Student in an Organized Health Care Education/Training Program | Massachusetts General Hospital, 55 Fruit Street., Boston, MA 02114 | 2020-08-24 |
1881223741 | Alexander Wesley Zirulnik | Student in an Organized Health Care Education/Training Program | 55 Fruit St. Boston, Boston, MA 02114 | 2020-04-03 |
1376170548 | Mia Yu Bothwell | Student in an Organized Health Care Education/Training Program | Gray Bigelow 730, 55 Fruit Street, Boston, MA 02114 | 2020-03-26 |
1225661036 | David Dongkyung Kim | Student in an Organized Health Care Education/Training Program | 6 Whittier Place, Apartment 15b, Boston, MA 02114 | 2020-02-20 |
1124651658 | Madeleine Sertic | Student in an Organized Health Care Education/Training Program | Division of Abdominal Imaging, Department of Radiology, 55 Fruit Street, White 270, Boston, MA 02114 | 2020-02-12 |
1285274498 | Jiuk James Jung | Student in an Organized Health Care Education/Training Program | 15 Parkman Ave, Wang 4-460, Boston, MA 02114 | 2020-01-15 |
1831740448 | Jennifer Hughes | Physician Assistant | 55 Fruit Street, Founders 110, Boston, MA 02114 | 2019-09-25 |
1558827220 | Aluma Chovel Sella | Student in an Organized Health Care Education/Training Program | Massgeneral Hospital for Children Main Campus, 55 Fruit Street, Boston, MA 02114 | 2019-02-18 |
1083187140 | Henry Oliveras | Massage Therapist | 102 Charles Street, Boston, MA 02114 | 2019-01-10 |
1720550031 | Nicole M Price | Social Worker | 29 Staniford St, Boston, MA 02114 | 2018-12-27 |
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Taxonomy Code | 2086S0120X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Pediatric Surgery |
A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629360680 | Cornelia Little Griggs | Surgery | 55 Fruit St Dept Of, Boston, MA 02114-2621 | 2011-05-10 |
1720270606 | Belinda Hsi Dickie | Surgery | 300 Longwood Ave # Fegan3, Boston, MA 02115-5724 | 2007-08-14 |
1346395076 | Patrick J Javid | Surgery | Children's Hospital Fegan 3, 300 Longwood Ave, Boston, MA 02115 | 2007-01-24 |
1285671875 | Mark Puder | Surgery | 300 Longwood Ave/fegan 3, Children's Hospital, Boston, MA 02115 | 2006-06-01 |
1326098419 | Brian F. Gilchrist | Surgery | 750 Washington Street, The Floating Hospital for Children, Boston, MA 02111 | 2006-05-11 |
1184936320 | Prathima Nandivada | Surgery | 300 Longwood Ave, Boston, MA 02115-5724 | 2010-07-03 |
1821317587 | Farokh Rustom Demehri | Surgery | 300 Longwood Ave, Boston, MA 02115-5724 | 2010-05-20 |
1326206152 | Artur Chernoguz | Surgery | 800 Washington St, Boston, MA 02111-1552 | 2008-05-29 |
1174794556 | Jill M Zalieckas | Surgery | 300 Longwood Ave, Fegan 3, Boston, MA 02115-5724 | 2008-03-13 |
1588871586 | Shawn J Rangel | Surgery | 300 Longwood Ave, Fegan 3, Boston, MA 02115-5724 | 2007-05-17 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.