Organization Active NPI

Cambridge Otolaryngology

  • Otolaryngology Physician
  • Cambridge, MA
National Provider Identifier
1083743835
Registry record updated Jul 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
CAMBRIDGE OTOLARYNGOLOGY
Practice address
300 Mount Auburn St
Suite 308
Cambridge, MA 02138-5600
Phone
(617) 354-1010
Fax
(617) 354-7961
NPI assigned
Mar 5, 2007
Last updated
Jul 22, 2010By the provider in NPPES
Organization subpart
Yes
Parent organization
CAMBRIDGE OTOLARYNGOLOGYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 22, 2010

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

Authorized official

Name
Mr. Robert E Leonard
Title
Office Manager
Phone
(617) 354-1010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

300 Mount Auburn St
Suite 308
Cambridge, MA 02138-5600

Mailing address

300 Mount Auburn St
Suite 308
Cambridge, MA 02138-5600
Phone (617) 354-1010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070713000499 MA Part B Supplier - Clinic/Group Practice 6406956853 Receives reassigned benefits from 5 practitioners
Practice locations: Cambridge, MA

National Provider Directory

National Provider Directory
Part of
Cambridge Otolaryngology

Locations

300 Mount Auburn St
Ste 308
Cambridge, MA 02138
Phone (617) 354-1010

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279756800000",
    "number": "1083743835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 MOUNT AUBURN ST",
            "address_2": "SUITE 308",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385600",
            "telephone_number": "617-354-1010",
            "fax_number": "617-354-7961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MOUNT AUBURN ST",
            "address_2": "SUITE 308",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385600",
            "telephone_number": "617-354-1010",
            "fax_number": "617-354-7961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CAMBRIDGE OTOLARYNGOLOGY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CAMBRIDGE OTOLARYNGOLOGY",
        "enumeration_date": "2007-03-05",
        "last_updated": "2010-07-22",
        "status": "A",
        "authorized_official_last_name": "LEONARD",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "617-354-1010",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.