Minimally Invasive Thoracic Surgery Associates, PC

Primary specialty

Thoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianTaxonomy code 208G00000X

Legal business name

MINIMALLY INVASIVE THORACIC SURGERY ASSOCIATES, PC

Practice address

800 W Cummings Park
Suite 4700
Woburn, MA 01801-6372

Phone

(781) 932-6487

Fax

(781) 932-6486

NPI assigned

May 5, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Produyt K Poddar, MD

Title

President

Phone

(617) 257-5945

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1241481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323129600000",
    "number": "1063646008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 MAIN ST",
            "address_2": "SUITE 670",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081604",
            "telephone_number": "508-454-3566",
            "fax_number": "508-438-6368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 W CUMMINGS PARK",
            "address_2": "SUITE 4700",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018016372",
            "telephone_number": "781-932-6487",
            "fax_number": "781-932-6486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MINIMALLY INVASIVE THORACIC SURGERY ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-05",
        "last_updated": "2011-12-06",
        "status": "A",
        "authorized_official_last_name": "PODDAR",
        "authorized_official_first_name": "PRODUYT",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-257-5945",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208G00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "M19736",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110083476A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Michelle Miller
• Rachel Gordon Miller, M.ED
• Maximilian Paul Milone
• Mindset Homecare LLC
• Mindy S Kopolow PSYD PA
• Minimally Invastive Thoracic Surgery Associates, P.C.
• Beatrice Mitchell, RN
• India Mitchell
• Mitra RXDX (MitraBiotech)
• Matthew James Mitrano

• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Woburn, MA
• Providers in Woburn, MA by specialty
• Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2011; 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.