Healthcare Provider Details
I. General information
NPI: 1831268754
Provider Name (Legal Business Name): CHMC ANESTHESIA FOUNDATION INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/07/2006
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
300 LONGWOOD AVE
BOSTON MA
02115-5724
US
IV. Provider business mailing address
300 LONGWOOD AVE
BOSTON MA
02115-5724
US
V. Phone/Fax
- Phone: 617-919-1340
- Fax: 617-919-1347
- Phone: 617-355-6000
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2080P0203X |
| Taxonomy | Pediatric Critical Care Medicine Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC0700X |
| Taxonomy | Clinical Psychologist |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LP2900X |
| Taxonomy | Pain Medicine (Anesthesiology) Physician |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363LP0200X |
| Taxonomy | Pediatric Nurse Practitioner |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103T00000X |
| Taxonomy | Psychologist |
| License Number | |
| License Number State | |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 103TC2200X |
| Taxonomy | Clinical Child & Adolescent Psychologist |
| License Number | |
| License Number State | |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2086S0120X |
| Taxonomy | Pediatric Surgery Physician |
| License Number | |
| License Number State | |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207LC0200X |
| Taxonomy | Critical Care Medicine (Anesthesiology) Physician |
| License Number | |
| License Number State | |
| # 11 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207LP3000X |
| Taxonomy | Pediatric Anesthesiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOSEPH
CRAVERO
Title or Position: CHIEF OF ANESTHESIA
Credential:
Phone: 617-355-8253