JONATHAN SETH FRIEDSTAT MD NPI 1316056245

NPI Information

NPI: 1316056245
Provider Name: JONATHAN SETH FRIEDSTAT, MD
Classification: Surgery - 2086S0122X
Entity Type: Individual

Specialization: Plastic and Reconstructive Surgery

PECOS Registration: Yes

Address:
55 FRUIT STREET
GRB 1303, FRASIER OUTPATIENT BURN CENTER
BOSTON, MA
ZIP 02114
Phone: (617) 726-3712
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Jonathan Seth Friedstat, MD is a plastic and reconstructive surgery surgery in Boston, MA with 18 years of experience. The provider is a surgeon who specializes in plastic and reconstructive surgery. Jonathan Seth Friedstat, MD NPI is 1316056245. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF ILLINOIS COLLEGE OF MED (CHI/PEOR/ROCK/CHM-URB)
Graduation Year:2006

The provider's business location address is:

55 FRUIT STREET
GRB 1303, FRASIER OUTPATIENT BURN CENTER
BOSTON, MA
ZIP 02114
Phone: (617) 726-3712

The NPI 1316056245 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 8/30/2006 and was last updated on 4/9/2018.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208600000X	Surgery		ML20008564	WASHINGTON	No
2	2086S0102X	Surgery	Surgical Critical Care	246710	MASSACHUSETTS	No
3	2086S0122X	Surgery	Plastic and Reconstructive Surgery	Q2768	TEXAS	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	347245801 (MDACC)	MEDICAID	TEXAS

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

NPI Synchronization or Removal

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