DR. JIBY YOHANNAN (NPI# 1790248730) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790248730 |
| Entity Type | Individual |
| Full Name | DR. JIBY YOHANNAN |
| Credential | MD |
| Practice Address |
275 Cambridge St Boston MA 02114-3108 |
| Mailing Address |
55 Fruit St Boston MA 02114-2696 |
| Practice Telephone | 6177262000 |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2019-04-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
275 CAMBRIDGE ST |
| City | BOSTON |
| State | MA |
| Zip Code | 02114-3108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982694287 | Allen Lapey | Allergy & Immunology | 275 Cambridge St, Suite 530, Boston, MA 02114-3130 | 2005-10-27 |
| 1467915900 | Abigail Helen Kallenberg | Student in an Organized Health Care Education/Training Program | 275 Cambridge St, Boston, MA 02114-3108 | 2019-04-11 |
| 1801357371 | Mariama Runcie | Student in an Organized Health Care Education/Training Program | 275 Cambridge St, Boston, MA 02114-3108 | 2019-03-27 |
| 1013477447 | Sravya Thulasi Challa | Student in an Organized Health Care Education/Training Program | 275 Cambridge St, Boston, MA 02114-3108 | 2019-03-21 |
| 1871053546 | Daniel Kwasi Amponsah | Student in an Organized Health Care Education/Training Program | 275 Cambridge St, Boston, MA 02114-3108 | 2019-03-20 |
| 1518426584 | Akhila Narla | Student in an Organized Health Care Education/Training Program | 275 Cambridge St, Boston, MA 02114-3108 | 2019-03-18 |
| 1073066262 | Alexander Ing | Genetic Counselor, MS | 275 Cambridge St, Suite 350, Boston, MA 02114-3108 | 2016-07-25 |
| 1982082012 | William Streicher Evans | Speech-Language Pathologist | 275 Cambridge St, Pob 3 Mass General Hospital, Boston, MA 02114-3108 | 2015-05-08 |
| 1679950497 | Magdalen Balz | Speech-Language Pathologist | 275 Cambridge St, Boston, MA 02114-3108 | 2015-04-30 |
| 1922410570 | Erin Vuijk | Speech-Language Pathologist | 275 Cambridge St, Pob 3, Boston, MA 02114-3108 | 2014-05-29 |
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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 | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447636 | Sarah Wieman | Student in an Organized Health Care Education/Training Program | 16 Blossom St Fl 1, Boston, MA 02114-3104 | 2020-11-03 |
| 1932709938 | Brianna Mae Duval | Student in an Organized Health Care Education/Training Program | 58 Colborne Rd, Boston, MA 02135-4103 | 2020-10-28 |
| 1780281279 | Sarah Hamad Alsaggabi | Student in an Organized Health Care Education/Training Program | 55 Traveler St Apt 1310, Boston, MA 02118-2973 | 2020-10-07 |
| 1821695933 | Matthew John Needham | Student in an Organized Health Care Education/Training Program | 330 Brookline Ave, Yamins 2nd Floor, Department of Anesthesia, Boston, MA 02215 | 2020-10-02 |
| 1013524339 | Jacqueline Busa | Student in an Organized Health Care Education/Training Program | Northeastern University 336 Huntington Ave, Boston, MA 02115 | 2020-09-30 |
| 1558978957 | Tien-hsin Chang | Student in an Organized Health Care Education/Training Program | 1 Kneeland Street (tufts University School of Dental Me, Boston, MA 02111 | 2020-09-29 |
| 1417564279 | Katherine Rose Brainard | Student in an Organized Health Care Education/Training Program | 336 Huntington Avenue, Boston, MA 02115 | 2020-09-25 |
| 1962018069 | Cara Connors | Student in an Organized Health Care Education/Training Program | 18 Wiget St Apt 1, Boston, MA 02113-2363 | 2020-09-23 |
| 1023624608 | Bernadette Avila | Student in an Organized Health Care Education/Training Program | 19 Peterborough St Apt 5, Boston, MA 02215-4409 | 2020-09-19 |
| 1588276281 | Guoliang Qiao | Student in an Organized Health Care Education/Training Program | Massachusetts General Hospital, 55 Fruit Street., Boston, MA 02114 | 2020-08-24 |
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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.