Organization Active NPI

Plastic Surgery of Southern New England, P.C.

  • Plastic Surgery Physician
  • Fall River, MA
National Provider Identifier
1114199080
Registry record updated Jan 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Plastic Surgery PhysicianTaxonomy code 208200000X
License
045581 Issued in MA
Legal business name
PLASTIC SURGERY OF SOUTHERN NEW ENGLAND, P.C.
Practice address
775 Davol St Ste 2
Fall River, MA 02720-1028
Phone
(508) 567-3202
Fax
(508) 678-1583
NPI assigned
Mar 31, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2025

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

Authorized official

Name
Megan Tabicas
Title
Practice Manager
Phone
(508) 567-3202

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Plastic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208200000X 045581 MA Primary

Addresses

Primary practice location

775 Davol St Ste 2
Fall River, MA 02720-1028

Mailing address

775 Davol St Ste 2
Fall River, MA 02720-1028
Phone (508) 567-3202

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1206921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736121600000",
    "number": "1114199080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "775 DAVOL ST STE 2",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027201028",
            "telephone_number": "508-567-3202",
            "fax_number": "508-678-1583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "775 DAVOL ST STE 2",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027201028",
            "telephone_number": "508-567-3202",
            "fax_number": "508-678-1583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC SURGERY OF SOUTHERN NEW ENGLAND, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-31",
        "last_updated": "2025-01-06",
        "certification_date": "2025-01-06",
        "status": "A",
        "authorized_official_last_name": "TABICAS",
        "authorized_official_first_name": "MEGAN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "508-567-3202"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Plastic Surgery",
            "state": "MA",
            "license": "045581",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fall River, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2025; 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.