MEDICARE: OAK STREET MEDICAL ASSOCIATES,PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RH0000X	Hematology (Internal Medicine) Physician	35581	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	C16101	OTHER	MA	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1598877144
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	OAK STREET MEDICAL ASSOCIATES,PC

Provider Business Mailing Address
First Line	:	300 CHESTNUT ST
Second Line	:	SUITE 700
City	:	NEEDHAM
State	:	MA
Zip	:	02492-2427
Country	:	US
Telephone Number	:	781-455-6200
Fax Number	:	781-449-1096

Provider Business Practice Location Address
First Line	:	300 CHESTNUT ST
Second Line	:	SUITE 700
City	:	NEEDHAM
State	:	MA
Zip	:	02492-2427
Country	:	US
Telephone Number	:	781-455-6200
Fax Number	:	781-449-1096

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. EARL L YUNES
Credential	:	MD
Telephone Number	:	781-455-6200

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	11/13/2007

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