DR. JOHN ELLERY MUNZENRIDER MD NPI 1215961206

NPI Information

NPI: 1215961206
Provider Name: DR. JOHN ELLERY MUNZENRIDER, MD
Classification: Radiology - 2085R0001X
Entity Type: Individual

Specialization: Radiation Oncology

Address:
55 FRUIT STREET
NPT 107 RADIATION ONCOLOGY
BOSTON, MA
ZIP 02114
Phone: (617) 726-6876
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DR. John Ellery Munzenrider, MD is a radiation oncology radiology in Boston, MA. The provider is a radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. DR. John Ellery Munzenrider, MD NPI is 1215961206. 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 STREET
NPT 107 RADIATION ONCOLOGY
BOSTON, MA
ZIP 02114-696
Phone: (617) 726-6876
Fax: (617) 726-2098

The enumeration date for this NPI number is 7/10/2006 and was last updated on 7/8/2007.

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	2085R0001X	Radiology	Radiation Oncology	32285	MASSACHUSETTS	Yes
2	2085R0203X	Radiology	Therapeutic Radiology	32285	MASSACHUSETTS	X

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	3059243	MEDICAID	MASSACHUSETTS
2	M07698	OTHER	MASSACHUSETTS	BCBS MA
3	A65942	MEDICARE UPIN
4	033285	OTHER	MASSACHUSETTS	TUFTS HEALTH PLAN
5	M07698	MEDICARE ID-TYPE UNSPECIFIED	MASSACHUSETTS

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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