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DR. KENNETH KENJI TANABE MD NPI 1164413613


NPI Information

NPI: 1164413613
Provider Name: DR. KENNETH KENJI TANABE, MD
Classification: Surgery - 208600000X
Entity Type: Individual

PECOS Registration: Yes

Address:
55 FRUIT ST
YAW 7B
BOSTON, MA
ZIP 02114
Phone: (617) 724-3868
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DR. Kenneth Kenji Tanabe, MD is a surgery in Boston, MA with 39 years of experience. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. DR. Kenneth Kenji Tanabe, MD NPI is 1164413613. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

55 FRUIT ST
YAW 7B
BOSTON, MA
ZIP 02114-621
Phone: (617) 724-3868
Fax: (617) 724-3895

The NPI 1164413613 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/3/2005 and was last updated on 11/6/2012.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208600000XSurgery78104MASSACHUSETTSYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1J13876OTHERMASSACHUSETTSBCBS MA
2E52123MEDICARE UPIN
33114015MEDICAIDMASSACHUSETTS
4078104OTHERMASSACHUSETTSTUFTS HEALTH PLAN
5J13876MEDICARE ID-TYPE UNSPECIFIEDMASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.