Individual provider Active NPI

Keith C Nobil, MD

  • Family Medicine Physician
  • Swampscott, MA
National Provider Identifier
1033118948
Registry record updated Dec 3, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
47988 Issued in MA
Practice address
250 Paradise Rd
Swampscott, MA 01907-2948
Phone
(781) 596-2000
Fax
(781) 595-7111
NPI assigned
Jul 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 47988 MA Primary

Addresses

Primary practice location

250 Paradise Rd
Swampscott, MA 01907-2948

Mailing address

148 East Ave
Suite 3H
Norwalk, CT 06851-5721
Phone (203) 354-6100

Other identifiers 1

IdentifierTypeStateIssuer
2088401MedicaidMA

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
I20050323000433 MA Practitioner - Family Practice 9032023353 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Southern California Keck School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Hutchinson Dr
Danvers, MA 01923-3748
Phone (978) 739-6950

1 Widger Rd
Marblehead, MA 01945-2146
Phone (781) 631-5726

250 Paradise Rd
Swampscott, MA 01907-2948
Phone (781) 596-2000

Hospital & facility affiliations

  • Mass General Brigham Home Care, Inc Home health agency, Newton, MA, CCN 227207
  • North Shore Medical Center - Hospital, Salem, MA, CCN 220035
  • Massachusetts General Hospital Hospital, Boston, MA, CCN 220071
  • Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171
  • Northeast Hospital Corporation Hospital, Beverly, MA, CCN 220033
  • Spaulding Rehabilitation Hospital Inpatient rehabilitation facility, Charlestown, MA, CCN 223034

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
47988MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Medical Group Northern Massachusetts Inc CurrentSince Sep 29, 2022 Accepting new patients

Locations

1 Hutchinson Dr
Danvers, MA 01923
Phone (978) 739-6950

250 Paradise Rd
Swampscott, MA 01907
Phone (781) 592-8462

Interoperability endpoints

  • Direct secure messaging: nobil.keith.nsmc@direct.partners.masshiway.net

Organizations & group practices 1

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 7

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": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1259798400000",
    "number": "1033118948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 EAST AVE",
            "address_2": "SUITE 3H",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068515721",
            "telephone_number": "203-354-6100",
            "fax_number": "203-354-6196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 PARADISE RD",
            "city": "SWAMPSCOTT",
            "state": "MA",
            "postal_code": "019072948",
            "telephone_number": "781-596-2000",
            "fax_number": "781-595-7111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOBIL",
        "first_name": "KEITH",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-21",
        "last_updated": "2009-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "47988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2088401",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Swampscott, MA

Sources for this page

Verify at the official NPI Registry.