NPIMap

Organization Active NPI

Quincy Pediatric Associates Inc

  • Pediatrics Physician
  • Quincy, MA
National Provider Identifier
1063582781
Registry record updated May 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
208000000X Issued in MA
Legal business name
QUINCY PEDIATRIC ASSOCIATES INC
Practice address
191 Independence Ave
Quincy, MA 02169-7751
Phone
(617) 773-5070
NPI assigned
Nov 9, 2006
Last updated
May 23, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2014

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

Authorized official

Name
Roberta Broderick
Title
Practice Manager
Phone
(781) 837-4044

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 208000000X MA Primary

Addresses

Primary practice location

191 Independence Ave
Quincy, MA 02169-7751

Mailing address

191 Independence Ave
Quincy, MA 02169-7751

Other identifiers 6

IdentifierTypeStateIssuer
552112OtherMAUNITED HEALTH CARE
600012BOtherMATUFTS HEALTH PLAN
M10943OtherMABLUE CROSS BLUE SHIELD
601040OtherMAHARVARD PILGRIM HEALTH CA
9101OtherMAAETNA
9700919MedicaidMA

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
22D0078249Quincy Pediatric Associates, Inc191 Independence Ave, Quincy, MA 02169ComplianceOct 3, 2026

National Provider Directory

National Provider Directory

Locations

769 Plain St
Ste F
Marshfield, MA 02050

191 Independence Ave
Quincy, MA 02169
Phone (617) 773-5070

Interoperability endpoints

  • Direct secure messaging: belcher.david.qui@direct.partners.masshiway.net
  • Direct secure messaging: christian.james.qui@direct.partners.masshiway.net
  • Direct secure messaging: hertko-adams.julianne.qui@direct.partners.masshiway.net
  • Direct secure messaging: irons.cherie.qui@direct.partners.masshiway.net
  • Direct secure messaging: irons.david.qui@direct.partners.masshiway.net
  • Direct secure messaging: jones.carrie.qui@direct.partners.masshiway.net
  • Direct secure messaging: mansour.kari.qui@direct.partners.masshiway.net
  • Direct secure messaging: mcgaugh.mary.qui@direct.partners.masshiway.net
  • Direct secure messaging: rosshirt.lindsay.qui@direct.partners.masshiway.net
  • Direct secure messaging: scharf.laura.qui@direct.partners.masshiway.net

Practitioners & affiliated clinicians

Practitioners 13

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 13

NPI Registry JSON

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400803200000",
    "number": "1063582781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 INDEPENDENCE AVE",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021697751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 INDEPENDENCE AVE",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021697751",
            "telephone_number": "617-773-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUINCY PEDIATRIC ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2014-05-23",
        "status": "A",
        "authorized_official_last_name": "BRODERICK",
        "authorized_official_first_name": "ROBERTA",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "781-837-4044"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "208000000X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "552112",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "600012B",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "M10943",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTH CA",
            "identifier": "601040",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9101",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9700919",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.