Organization Active NPI

Boston Community Pediatrics Inc

  • Pediatrics Physician
  • Boston, MA
National Provider Identifier
1053927574
Registry record updated Oct 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
BOSTON COMMUNITY PEDIATRICS INC
Practice address
527 Albany St Ste 200
Boston, MA 02118-2511
Phone
(617) 934-6009
Fax
(617) 934-7102
NPI assigned
Sep 21, 2020
Last updated
Oct 8, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2020

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

Authorized official

Name
Robyn Riseberg, MDNPI 1770562282
Title
Authorized Official
Phone
(617) 934-6009

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

527 Albany St Ste 200
Boston, MA 02118-2511

Mailing address

527 Albany St Ste 200
Boston, MA 02118-2511
Phone (617) 934-6009

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201204001354 MA Part B Supplier - Clinic/Group Practice 9830500388 Receives reassigned benefits from 9 practitioners
Practice locations: Boston, MA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D2204268Boston Community Pediatrics Inc527 Albany St, Boston, MA 02118Certificate of waiverDec 7, 2026

National Provider Directory

National Provider Directory

Locations

527 Albany St
Boston, MA 02118

527 Albany St
#200
Boston, MA 02118
Phone (617) 934-6009

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/22231/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1600646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602115200000",
    "number": "1053927574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 ALBANY ST STE 200",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182511",
            "telephone_number": "617-934-6009",
            "fax_number": "617-934-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "527 ALBANY ST STE 200",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182511",
            "telephone_number": "617-934-6009",
            "fax_number": "617-934-7102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON COMMUNITY PEDIATRICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-21",
        "last_updated": "2020-10-08",
        "certification_date": "2020-10-08",
        "status": "A",
        "authorized_official_last_name": "RISEBERG",
        "authorized_official_first_name": "ROBYN",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "617-934-6009",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.