Active NPI
Southcoast Physician Services Inc
- Internal Medicine Physician
- Fall River, MA
National Provider Identifier
1104874874
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- Legal business name
- SOUTHCOAST PHYSICIAN SERVICES INC
- Practice address
- 1030 President Ave
Suite 104
Fall River, MA 02720-5923 - Phone
- (508) 676-3411
- Fax
- (508) 235-6656
- NPI assigned
- May 5, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mary M Hodgson
- Title
- Director of Finance
- Phone
- (508) 985-2011
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | Primary | ||
| Gastroenterology Physician | 207RG0100X |
Addresses
Primary practice location
1030 President Ave
Suite 104
Fall River, MA 02720-5923
Mailing address
1030 President Ave
Suite 104
Fall River, MA 02720-5923
Phone (508) 676-3411
Other identifiers 9
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9704876 | Medicaid | MA | |
| M17689 | Other | MA | BC BS OF MASS |
| 004236 | Other | RI | BLUE CHIP |
| B10187907 | Other | MA | CIGNA |
| 0000025599 | Other | RI | BC BS OF RI |
| 0021912 | Other | MA | NEIGHBORHOOD HEALTH |
| 000000021264 | Other | MA | BMC HEALTHNET |
| 44108 | Other | MA | AETNA US HEALTHCARE |
| 620388 | Other | MA | TUFTS |
Other names 1
- Truesdale Medical Specialties Associates
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050502000716 | RI | Part B Supplier - Clinic/Group Practice | 0749171957 |
Receives reassigned benefits from 133 practitioners 1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Middletown, RI; Warwick, RI; Tiverton, RI; Providence, RI; Portsmouth, RI; Pawtucket, RI |
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
- Family Medicine Physician
- Fairhaven, MA
- NPI 1336137629
O20050502000716
National Provider Directory
National Provider DirectoryLocations
1030 President Ave
#306C
Fall River, MA 02720
Phone (508) 676-3411
Ownership & related parties
Subparts reporting this organization as parent 1
Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.
-
- Surgery Physician
- Wareham, MA
- NPI 1497956254
Practitioners & affiliated clinicians
Practitioners 11
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Cytopathology Physician
- Fall River, MA
- NPI 1164494456
-
- Nurse Practitioner
- Fall River, MA
- NPI 1184672925
-
- Internal Medicine Physician
- Fall River, MA
- NPI 1477519080
Internal Medicine
-
- Family Medicine Physician
- Fall River, MA
- NPI 1093770059
-
- Sports Medicine (Family Medicine) Physician
- Mount Pleasant, SC
- NPI 1497719355
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1757548800000",
"number": "1104874874",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1030 PRESIDENT AVE",
"address_2": "SUITE 104",
"city": "FALL RIVER",
"state": "MA",
"postal_code": "027205923",
"telephone_number": "508-676-3411",
"fax_number": "508-235-6656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1030 PRESIDENT AVE",
"address_2": "SUITE 104",
"city": "FALL RIVER",
"state": "MA",
"postal_code": "027205923",
"telephone_number": "508-676-3411",
"fax_number": "508-235-6656"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SOUTHCOAST PHYSICIAN SERVICES INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-05",
"last_updated": "2025-09-11",
"status": "A",
"authorized_official_last_name": "HODGSON",
"authorized_official_first_name": "MARY",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "DIRECTOR OF FINANCE",
"authorized_official_telephone_number": "508-985-2011"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207RG0100X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Gastroenterology",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9704876",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS OF MASS",
"identifier": "M17689",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CHIP",
"identifier": "004236",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "B10187907",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC BS OF RI",
"identifier": "0000025599",
"state": "RI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBORHOOD HEALTH",
"identifier": "0021912",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BMC HEALTHNET",
"identifier": "000000021264",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA US HEALTHCARE",
"identifier": "44108",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "620388",
"state": "MA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Truesdale Medical Specialties Associates",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Fall River, MA
- Southcoast Hospitals Group
- Southcoast Hospitals Group Inc
- Southcoast Hospitals Group, Inc
- Southcoast Hospitals Group, Inc
- Southcoast Hospitals Group,Inc
- Southcoast Physicians Group, Inc.
- Southcoast Physicians Group, Inc.
- Southcoast Physicians Group, Inc.
- Southcoast Womans Care PC
- Southeast Center for Independent Living
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.