Active NPI
Stephen Patrick Tubridy, D.P.M.
- Foot Surgery Podiatrist
- Chestnut Hill, MA
National Provider Identifier
1104840974
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot Surgery Podiatrist
- License
- 1906
- Practice address
- 1244 Boylston St
Suite 101
Chestnut Hill, MA 02467-2116 - Phone
- (617) 232-1752
- Fax
- (617) 566-1919
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot Surgery Podiatrist | 213ES0131X | 1906 | MA | Primary |
Addresses
Primary practice location
1244 Boylston St
Suite 101
Chestnut Hill, MA 02467-2116
Mailing address
1244 Boylston St
Suite 101
Chestnut Hill, MA 02467-2116
Phone (617) 232-1752
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0362948 | Medicaid | MA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1906 | MA | MD | Behavioral Analyst |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104840974",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1244 BOYLSTON ST",
"address_2": "SUITE 101",
"city": "CHESTNUT HILL",
"state": "MA",
"postal_code": "024672116",
"telephone_number": "617-232-1752",
"fax_number": "617-566-1919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1244 BOYLSTON ST",
"address_2": "SUITE 101",
"city": "CHESTNUT HILL",
"state": "MA",
"postal_code": "024672116",
"telephone_number": "617-232-1752",
"fax_number": "617-566-1919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUBRIDY",
"first_name": "STEPHEN",
"middle_name": "PATRICK",
"name_prefix": "Dr.",
"credential": "D.P.M.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0131X",
"taxonomy_group": "",
"desc": "Podiatrist, Foot Surgery",
"state": "MA",
"license": "1906",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0362948",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chestnut Hill, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.