| Chmc Otolaryngologic Foundation, Inc | |
|
300 Longwood Ave Lo 367 Boston MA 02115-5724 | |
| (617) 355-6460 | |
| (617) 730-0611 |
| Full Name | Chmc Otolaryngologic Foundation, Inc |
|---|---|
| Speciality | Otolaryngology |
| Location | 300 Longwood Ave, Boston, Massachusetts |
| Authorized Official Name and Position | Norman Dean (DEPARTMENT ADMINISTRATOR) |
| Authorized Official Contact | 6173556463 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chmc Otolaryngologic Foundation, Inc Po Box 4162 Woburn MA 01888-4162 Ph: (617) 355-6460 | Chmc Otolaryngologic Foundation, Inc 300 Longwood Ave Lo 367 Boston MA 02115-5724 Ph: (617) 355-6460 |
| NPI Number | 1124118229 |
|---|---|
| Provider Enumeration Date | 10/13/2006 |
| Last Update Date | 07/08/2025 |
| Certification Date | 07/08/2025 |
| Medicare PECOS PAC ID | 9234102526 |
|---|---|
| Medicare Enrollment ID | O20040816000514 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124118229 | NPI | - | NPPES |
| 110028764B | Other | MA | MEDICAID PID |
| 9723153 | Medicaid | MA |
| Provider Name | Dennis S Poe |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1699749002 PECOS PAC ID: 4082654025 Enrollment ID: I20050509000853 |
| Provider Name | Margaret A Kenna |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1689646366 PECOS PAC ID: 6406892652 Enrollment ID: I20050628001272 |
| Provider Name | Heather Rauch |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1457320251 PECOS PAC ID: 0446251326 Enrollment ID: I20070119000041 |
| Provider Name | Reza Rahbar |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1780657494 PECOS PAC ID: 1951484047 Enrollment ID: I20080213000187 |
| Provider Name | Roger Charles Nuss |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1770556458 PECOS PAC ID: 0840374336 Enrollment ID: I20080221000588 |
| Provider Name | Guangwei Zhou |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1336203330 PECOS PAC ID: 2163596719 Enrollment ID: I20080731000272 |
| Provider Name | Gi Soo Lee |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1265444749 PECOS PAC ID: 0345308995 Enrollment ID: I20081025000144 |
| Provider Name | Susan M Gibbons |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1912199308 PECOS PAC ID: 9931268893 Enrollment ID: I20081106000539 |
| Provider Name | Lisa Walker |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1215902903 PECOS PAC ID: 9032272638 Enrollment ID: I20090108000120 |
| Provider Name | Karen Watters |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1609001114 PECOS PAC ID: 1254485097 Enrollment ID: I20090813000558 |
| Provider Name | Kenneth R Whittemore |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1295767184 PECOS PAC ID: 0244377059 Enrollment ID: I20091028000142 |
| Provider Name | Greg R Licameli |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1841263373 PECOS PAC ID: 3274672068 Enrollment ID: I20091208000638 |
| Provider Name | Rita M Garrido |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1760613814 PECOS PAC ID: 9830221662 Enrollment ID: I20100714000769 |
| Provider Name | Laurie A Ohlms |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1396718078 PECOS PAC ID: 7113114786 Enrollment ID: I20101208000628 |
| Provider Name | Michael J Cunningham |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1811988181 PECOS PAC ID: 5193913374 Enrollment ID: I20110104000088 |
| Provider Name | Jacob R Brodsky |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1487819785 PECOS PAC ID: 5395914410 Enrollment ID: I20110808000044 |
| Provider Name | Kara R Larson |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1164496048 PECOS PAC ID: 7810166931 Enrollment ID: I20110808000067 |
| Provider Name | Kayla O Hernandez |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1669751244 PECOS PAC ID: 4385815455 Enrollment ID: I20110921000305 |
| Provider Name | Rachel M Santiago |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1245510577 PECOS PAC ID: 1355515107 Enrollment ID: I20111114000524 |
| Provider Name | Jennifer A Perez |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1669445383 PECOS PAC ID: 1759542657 Enrollment ID: I20120420000331 |
| Provider Name | Eelam S Adil |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1912129990 PECOS PAC ID: 5395994198 Enrollment ID: I20121011000814 |
| Provider Name | Carleton Corrales |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1376814525 PECOS PAC ID: 0244490076 Enrollment ID: I20150113000110 |
| Provider Name | Anne F Hseu |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1477727683 PECOS PAC ID: 1951529072 Enrollment ID: I20150910001228 |
| Provider Name | Rachel C Rhodes |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1295196897 PECOS PAC ID: 1355649393 Enrollment ID: I20160407001596 |
| Provider Name | Aaron K Remenschneider |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1689801482 PECOS PAC ID: 3971763988 Enrollment ID: I20160920002255 |
| Provider Name | Lindsay B Sobin |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1518278936 PECOS PAC ID: 8921396664 Enrollment ID: I20161012000467 |
| Provider Name | Nicole S Salamy |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1548711922 PECOS PAC ID: 1355623927 Enrollment ID: I20170117001913 |
| Provider Name | Sukgi S Choi |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1336229079 PECOS PAC ID: 4789853664 Enrollment ID: I20170323000122 |
| Provider Name | Victoria C Albano |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891128146 PECOS PAC ID: 4486953213 Enrollment ID: I20170417001381 |
| Provider Name | Kate S Mysak |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801262050 PECOS PAC ID: 6608184684 Enrollment ID: I20180427001699 |
| Provider Name | Kaitlyn S Fitzpatrick |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1679985303 PECOS PAC ID: 9234463993 Enrollment ID: I20190628002577 |
| Provider Name | Meredith S Sager |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1306328950 PECOS PAC ID: 1658706585 Enrollment ID: I20200122002470 |
| Provider Name | Katie M Fleischman |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1639421498 PECOS PAC ID: 1355660523 Enrollment ID: I20200508000553 |
| Provider Name | Aiden Shearer |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1457765224 PECOS PAC ID: 2062638364 Enrollment ID: I20200909001945 |
| Provider Name | Sara C Gallant |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1457785297 PECOS PAC ID: 2365862174 Enrollment ID: I20201016001148 |
| Provider Name | Yasmin S Dever |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1700400421 PECOS PAC ID: 0244620342 Enrollment ID: I20211203001946 |
| Provider Name | Juliet Maccrate |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1154905024 PECOS PAC ID: 7719369149 Enrollment ID: I20220802002668 |
| Provider Name | Brett L Radosti |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1801308002 PECOS PAC ID: 0244612422 Enrollment ID: I20220804001444 |
| Provider Name | Rachel J Painter |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1700480621 PECOS PAC ID: 7517341365 Enrollment ID: I20220829002253 |
| Provider Name | Nina Ruth Williams |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1407260912 PECOS PAC ID: 6709254006 Enrollment ID: I20221117000950 |
| Provider Name | Miriam El-haoui |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1225774334 PECOS PAC ID: 5597137802 Enrollment ID: I20230215001274 |
| Provider Name | Elizabeth Erickson O'neill |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1073670717 PECOS PAC ID: 2466818984 Enrollment ID: I20230525000351 |
| Provider Name | Taryn Elizabeth Cronin |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1083956106 PECOS PAC ID: 6800253162 Enrollment ID: I20230601002585 |
| Provider Name | Jude Albukhari |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063084648 PECOS PAC ID: 0941662423 Enrollment ID: I20230815003889 |
| Provider Name | Carolyn A Babeu |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1578113502 PECOS PAC ID: 6204281702 Enrollment ID: I20231018000443 |
| Provider Name | Holly J Miller |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1790321644 PECOS PAC ID: 7911353156 Enrollment ID: I20231025000919 |
| Provider Name | Maria Levit |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1932884582 PECOS PAC ID: 0143676866 Enrollment ID: I20231031003229 |
| Provider Name | Sabrina Mai Barkal |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1285351825 PECOS PAC ID: 9436505161 Enrollment ID: I20231031003630 |
| Provider Name | Jessica Renee Handler |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1841660776 PECOS PAC ID: 3678920428 Enrollment ID: I20231115003478 |
| Provider Name | Kelsey C Mercado |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093583502 PECOS PAC ID: 4880047505 Enrollment ID: I20240130001272 |
| Provider Name | Meaghan E Lussier |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1427800739 PECOS PAC ID: 0143661041 Enrollment ID: I20240509001521 |
| Provider Name | Brittany J Bullock |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1053166074 PECOS PAC ID: 1759722556 Enrollment ID: I20240510001354 |
| Provider Name | Emma K Rademacher |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1043059926 PECOS PAC ID: 8628510732 Enrollment ID: I20240604003974 |
| Provider Name | Corinne C Myjak |
|---|---|
| Provider Type | Practitioner - Qualified Speech Language Pathologist |
| Provider Identifiers | NPI Number: 1992548580 PECOS PAC ID: 0244773737 Enrollment ID: I20240625003013 |
| Provider Name | Claire Marie Lawlor |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1760742159 PECOS PAC ID: 0648571695 Enrollment ID: I20240819003429 |
| Provider Name | Erika Mercier |
|---|---|
| Provider Type | Practitioner - Otolaryngology |
| Provider Identifiers | NPI Number: 1659844058 PECOS PAC ID: 6608314760 Enrollment ID: I20240820003367 |
| Provider Name | Jennifer Amato |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1750759940 PECOS PAC ID: 3971915539 Enrollment ID: I20241210000751 |
| Provider Name | Derek Jason Stiles |
|---|---|
| Provider Type | Practitioner - Qualified Audiologist |
| Provider Identifiers | NPI Number: 1750436150 PECOS PAC ID: 2163959354 Enrollment ID: I20241230002857 |
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