Individual provider Active NPI

Elena Doina Dragoi, M.D

  • Pediatrics Physician
  • West Bridgewater, MA
National Provider Identifier
1003962739
Registry record updated Nov 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
0142632 Issued in CT
Practice address
291 E. Center St
West Bridgewater, MA 02379
Phone
(508) 584-1210
Fax
(774) 776-1172
NPI assigned
Jan 26, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 0142632 CT Primary
Pediatrics Physician 208000000X 245974 MA

Addresses

Primary practice location

291 E. Center St
West Bridgewater, MA 02379

Mailing address

291 E. Center Street
Pediatric Associates of Brockton Inc.
West Bridgewater, MA 02379
Phone (508) 584-1210

Other identifiers 1

IdentifierTypeStateIssuer
00426320MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20141110000281 CT Practitioner - Pediatric Medicine 3274755178 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0142632CTMDPediatrics Physician
245974MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optimus Health Care Inc CurrentSince Oct 1, 2014 Accepting new patients
Pediatric Associates Inc. of Brockton Pediatrics Past Accepting new patients

Locations

982 E Main St
Bridgeport, CT 06608
Phone (203) 696-3260

471 Barnum Ave
Bridgeport, CT 06608
Phone (203) 333-6864

Interoperability endpoints

  • Direct secure messaging: edragoi180243@direct.ynhh.org

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.

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384992000000",
    "number": "1003962739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "291 E. CENTER STREET",
            "address_2": "PEDIATRIC ASSOCIATES OF BROCKTON INC.",
            "city": "WEST BRIDGEWATER",
            "state": "MA",
            "postal_code": "02379",
            "telephone_number": "508-584-1210",
            "fax_number": "774-776-1172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 E. CENTER ST",
            "city": "WEST BRIDGEWATER",
            "state": "MA",
            "postal_code": "02379",
            "telephone_number": "508-584-1210",
            "fax_number": "774-776-1172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRAGOI",
        "first_name": "ELENA",
        "middle_name": "DOINA",
        "name_prefix": "Mrs.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-26",
        "last_updated": "2013-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "0142632",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "245974",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00426320",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bridgewater, MA

Sources for this page

Verify at the official NPI Registry.