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NPI Code Detail

MEDICARE: CHILDREN'S SPORTS MEDICINE FOUNDATION INC.

MEDICARE: CHILDREN'S SPORTS MEDICINE FOUNDATION INC.
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
1207PS0010XSports Medicine (Emergency Medicine) Physician
2103TC0700XClinical Psychologist
3213E00000XPodiatrist
4363LP0200XPediatric Nurse Practitioner
52080S0010XPediatric Sports Medicine Physician
6213ES0000XSports Medicine Podiatrist
7363A00000XPhysician Assistant
8207QS0010XSports Medicine (Family Medicine) Physician
9207XX0005XSports Medicine (Orthopaedic Surgery) Physician
10207X00000XOrthopaedic Surgery Physician

General Provider Information

NPI Number : 1740216811
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHILDREN'S SPORTS MEDICINE FOUNDATION INC.
Provider Business Mailing Address
First Line : 300 LONGWOOD AVE
Second Line :
City : BOSTON
State : MA
Zip : 02115-5724
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 300 LONGWOOD AVE
Second Line :
City : BOSTON
State : MA
Zip : 02115-5724
Country : US
Telephone Number : 617-355-5971
Fax Number : 617-730-0178
Authorized Official
Title or Position : DIVISION CHIEF
Name : MININDER KOCHER
Credential :
Telephone Number : 617-355-3501
Provider Enumeration Date : 06/23/2006
Last Update Date : 02/10/2026

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Directions to “CHILDREN'S SPORTS MEDICINE FOUNDATION INC. ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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