NPIMap

Organization Active NPI

Coolidge Corner Imaging, LLC

  • Diagnostic Radiology Physician
  • Brookline, MA
National Provider Identifier
1043364920
Registry record updated Dec 7, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
COOLIDGE CORNER IMAGING, LLC
Practice address
356 Harvard St
Brookline, MA 02446-2905
Phone
(617) 383-6585
Fax
(617) 383-6592
NPI assigned
Jan 22, 2007
Last updated
Dec 7, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2010

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

Authorized official

Name
Jean Pierce
Title
Office Manager
Phone
(617) 661-1949

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

356 Harvard St
Brookline, MA 02446-2905

Mailing address

PO Box 381289
31 Smith Place
Cambridge, MA 02238-1289
Phone (617) 661-1949

Other identifiers 3

IdentifierTypeStateIssuer
831660OtherMATUFTS
9750240MedicaidMA
M18932OtherMABLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 21

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 21

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291680000000",
    "number": "1043364920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 381289",
            "address_2": "31 SMITH PLACE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "022381289",
            "telephone_number": "617-661-1949",
            "fax_number": "617-661-1943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "356 HARVARD ST",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024462905",
            "telephone_number": "617-383-6585",
            "fax_number": "617-383-6592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COOLIDGE CORNER IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2010-12-07",
        "status": "A",
        "authorized_official_last_name": "PIERCE",
        "authorized_official_first_name": "JEAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "617-661-1949"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "831660",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9750240",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "M18932",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2010; 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.