Individual provider Active NPI

Kathleen Eva White, D.O.

  • Internal Medicine Physician
  • Marlborough, MA
National Provider Identifier
1003907080
Registry record updated Dec 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
209026 Issued in MA
Practice address
340 Maple St
Suite 203
Marlborough, MA 01752-3200
Phone
(508) 485-7779
Fax
(508) 485-7769
NPI assigned
Sep 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 209026 MA Primary

Addresses

Primary practice location

340 Maple St
Suite 203
Marlborough, MA 01752-3200

Mailing address

340 Maple St
Suite 203
Marlborough, MA 01752-3200
Phone (508) 485-7779

Other identifiers 1

IdentifierTypeStateIssuer
0148415MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100504000705 MA Practitioner - Internal Medicine 2961530498 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of New England, College of Osteo Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Louis Kuchnir MD PCGroup PAC ID 0143270868, 17 clinicians

Practice addresses (Care Compare)

11 Apex Dr
Suite 103a
Marlborough, MA 01752-1860
Phone 5084857779857779

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions804
Skin biopsy210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Lahey Clinic, Inc. Internal Medicine CurrentSince Jul 18, 2001 Accepting new patients
Louis Kuchnir MD PC CurrentSince Jan 1, 2014 Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

340 Maple St
Ste 203
Marlborough, MA 01752
Phone (508) 485-7779

11 Apex Dr
Ste 103A
Marlborough, MA 01752
Phone (508) 485-7779

1 Maple St
Milford, MA 01757
Phone (508) 478-2610

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387411200000",
    "number": "1003907080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 MAPLE ST",
            "address_2": "SUITE 203",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017523200",
            "telephone_number": "508-485-7779",
            "fax_number": "508-485-7769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 MAPLE ST",
            "address_2": "SUITE 203",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017523200",
            "telephone_number": "508-485-7779",
            "fax_number": "508-485-7769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "KATHLEEN",
        "middle_name": "EVA",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-27",
        "last_updated": "2013-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "209026",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0148415",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marlborough, MA

Sources for this page

Verify at the official NPI Registry.