JONATHAN PAEK (NPI# 1831519040) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831519040 |
| Entity Type | Individual |
| Full Name | JONATHAN PAEK |
| Practice Address |
55 Fruit St Boston MA 02114 |
| Mailing Address |
55 Fruit St Boston MA 02114-2621 |
| Practice Telephone | 4045616161 |
| Enumeration Date | 2014-04-27 |
| Last Update Date | 2019-05-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207L00000X | Anesthesiology | BP10049549 | TX | Allopathic & Osteopathic Physicians |
| N | 207LP2900X |
Anesthesiology Specialization: Pain Medicine |
276143 | MA | Allopathic & Osteopathic Physicians |
| Y | 208VP0014X |
Pain Medicine Specialization: Interventional Pain Medicine |
S0043 | TX | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7315 Brompton St, Apt 355b, Houston, TX 770252100 | 4045616161 | |
| 9100 Forest Xing Ste A, The Woodlands, TX 773811194 | 9367554412 |
| Street Address |
55 FRUIT ST |
| City | BOSTON |
| State | MA |
| Zip Code | 02114 |
| 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 |
| Find all providers in the same location | ||||
| 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 |
| Find all providers in zip 02114 | ||||
| Taxonomy Code | 208VP0014X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pain Medicine |
| Specialization | Interventional Pain Medicine |
| Interventional Pain Medicine is the discipline of medicine devoted to the diagnosis and treatment of pain and related disorders principally with the application of interventional techniques in managing subacute, chronic, persistent, and intractable pain, independently or in conjunction with other modalities of treatment. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497763213 | Cap Anesthesia, PC | Pain Medicine | 736 Cambridge St, Boston, MA 02135-2907 | 2006-08-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336635606 | Orthopedic Medicine of Boston Pllc | Pain Medicine | 300 Congress St Ste 304, Quincy, MA 02169-0907 | 2018-07-10 |
| 1225335417 | Impar Corporation | Pain Medicine | 178 Westerly Rd, Plymouth, MA 02360-4535 | 2011-02-24 |
| 1609010008 | James R Gorman | Pain Medicine | 888 Worcester St Ste 95, Wellesley, MA 02482-3737 | 2009-04-29 |
| 1831189364 | Omar Hammam El Abd | Pain Medicine | 378 Washington St, Wellesley, MA 02481-6207 | 2005-10-26 |
| 1568972958 | North Shore Pain Center LLC | Pain Medicine | 900 Cummings Ctr Ste 221u, Beverly, MA 01915-6183 | 2017-10-11 |
| 1326574872 | North Shore Pain Treatment LLC | Pain Medicine | 900 Cummings Ctr, Suite 221u, Beverly, MA 01915-6198 | 2017-05-03 |
| 1942678560 | Orthopedics New England, Inc | Pain Medicine | 313 Speen St, Natick, MA 01760-1538 | 2015-09-14 |
| 1750779328 | Christopher James Britt | Pain Medicine | 203 Turnpike St, G1, North Andover, MA 01845-5042 | 2015-01-05 |
| 1174928543 | Seacoast Pain Center, LLC | Pain Medicine | 21 Highland Ave, Suite 16, Newburyport, MA 01950-3872 | 2014-10-28 |
| 1144643370 | North Shore Pain Care LLC | Pain Medicine | 800 W Cummings Park, Suite 1200, Woburn, MA 01801-6372 | 2014-01-23 |
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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.