NPIMap

Organization Active NPI

Mt Auburn Professional Services

  • Internal Medicine Physician
  • Somerville, MA
National Provider Identifier
1013921790
Registry record updated May 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MT AUBURN PROFESSIONAL SERVICES
Practice address
20 Holland St
Suite 407
Somerville, MA 02144-2700
Phone
(978) 658-5577
Fax
(978) 658-5587
NPI assigned
Jul 28, 2006
Organization subpart
Yes
Parent organization
MT AUBURN PROFESSIONAL SERVICESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 5, 2024

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

Authorized official

Name
Mr. Brian Smith
Title
Cfo
Phone
(405) 245-6238

Specialties & licenses 1

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

Addresses

Primary practice location

20 Holland St
Suite 407
Somerville, MA 02144-2700

Mailing address

PO Box 419
Lynnfield, MA 01940-0419
Phone (978) 658-5577

National Provider Directory

National Provider Directory
Tax ID family
Mt Auburn Prof SVCS Inc7 organizations share this tax ID, including this one
Part of
Mt Auburn Prof SVCS Inc

Other organizations with this tax ID 6

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

Practitioners & affiliated clinicians

Practitioners 1

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": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714867200000",
    "number": "1013921790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 419",
            "city": "LYNNFIELD",
            "state": "MA",
            "postal_code": "019400419",
            "telephone_number": "978-658-5577",
            "fax_number": "978-658-5587"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 HOLLAND ST",
            "address_2": "SUITE 407",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021442700",
            "telephone_number": "978-658-5577",
            "fax_number": "978-658-5587"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT AUBURN PROFESSIONAL SERVICES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MT AUBURN PROFESSIONAL SERVICES",
        "enumeration_date": "2006-07-28",
        "last_updated": "2024-05-05",
        "certification_date": "2024-05-05",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "405-245-6238",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.