NPIMap

Individual provider Active NPI

Ghadam Tom Biuckians, M.D.

  • Surgery Physician
  • Waltham, MA
National Provider Identifier
1073583456
Registry record updated Mar 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
39064 Issued in MA
Practice address
808 Main St
Waltham, MA 02451-8533
Phone
(781) 893-5447
Fax
(781) 894-3037
NPI assigned
Jan 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 39064 MA Primary

Addresses

Primary practice location

808 Main St
Waltham, MA 02451-8533

Mailing address

2014 Washington St
Gmob Ste 563
Newton, MA 02462

Other identifiers 1

IdentifierTypeStateIssuer
2052474MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Wound Recovery - Boston, LLC Past Accepting new patients
Newton-Wellesley Hospital Past Accepting new patients
Vicki Heller, MD/Gentle Gynecology Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1138233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456963200000",
    "number": "1073583456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2014 WASHINGTON ST",
            "address_2": "GMOB STE 563",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "02462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 MAIN ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024518533",
            "telephone_number": "781-893-5447",
            "fax_number": "781-894-3037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIUCKIANS",
        "first_name": "GHADAM",
        "middle_name": "TOM",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-26",
        "last_updated": "2016-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "39064",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2052474",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2016; 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.