Organization Active NPI

Blue Hills Medical Associates

  • Internal Medicine Physician
  • Braintree, MA
National Provider Identifier
1003966862
Registry record updated Aug 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
BLUE HILLS MEDICAL ASSOCIATES
Practice address
340 Wood Rd
Suite 203
Braintree, MA 02184-2401
Phone
(781) 849-1111
NPI assigned
Jan 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2010

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

Authorized official

Name
Mrs. Pooja Singh
Title
Business Manager
Phone
(781) 794-2214

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

340 Wood Rd
Suite 203
Braintree, MA 02184-2401

Mailing address

340 Wood Rd
Suite 203
Braintree, MA 02184-2401

Other identifiers 1

IdentifierTypeStateIssuer
M17490OtherMABLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041215000774 MA Part B Supplier - Clinic/Group Practice 0042277667 Receives reassigned benefits from 3 practitioners
Practice locations: Braintree, MA

National Provider Directory

National Provider Directory
Tax ID family
Blue Hills Medical Associates2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

340 Wood Rd
Ste 100
Braintree, MA 02184

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283212800000",
    "number": "1003966862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 WOOD RD",
            "address_2": "SUITE 203",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021842401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 WOOD RD",
            "address_2": "SUITE 203",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021842401",
            "telephone_number": "781-849-1111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE HILLS MEDICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2010-08-31",
        "status": "A",
        "authorized_official_last_name": "SINGH",
        "authorized_official_first_name": "POOJA",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "781-794-2214",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "M17490",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Braintree, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.