Individual provider Active NPI

Paul R Coutu, MD

  • Internal Medicine Physician
  • Brockton, MA
National Provider Identifier
1114911757
Registry record updated Jan 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
42565 Issued in MA
Practice address
1 Pearl St
Suite 1400
Brockton, MA 02301-2864
Phone
(508) 897-6200
Fax
(508) 897-6321
NPI assigned
Sep 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 42565 MA Primary

Addresses

Primary practice location

1 Pearl St
Suite 1400
Brockton, MA 02301-2864

Mailing address

1 Pearl St
Suite 1400
Brockton, MA 02301-2864
Phone (508) 897-6200

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

State licenses

LicenseStateTypeSpecialty
42565MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince Nov 6, 2010 Accepting new patients
Steward Medical Group, Inc PastSince Nov 6, 2010 Accepting new patients
Bridgewater Pediatrics LLC Past Accepting new patients
Caritas Medical Group, Inc. Past Accepting new patients
Middlesex Recovery Professional Corporation PastSince Jan 1, 2020 Accepting new patients

Locations

11 Nevins St
Ste 401
Brighton, MA 02135
Phone (617) 682-7788

11 Nevins St
Ste 306
Brighton, MA 02135
Phone (617) 789-2045

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

1 Pearl St
Ste 1400
Brockton, MA 02301
Phone (508) 897-6030

104 Liberty St
Hanson, MA 02341
Phone (617) 293-5454

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

907 Sumner St
Ste 202
Stoughton, MA 02072
Phone (781) 297-8020

Organizations & group practices 5

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": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295568000000",
    "number": "1114911757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PEARL ST",
            "address_2": "SUITE 1400",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023012864",
            "telephone_number": "508-897-6200",
            "fax_number": "508-897-6321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PEARL ST",
            "address_2": "SUITE 1400",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023012864",
            "telephone_number": "508-897-6200",
            "fax_number": "508-897-6321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COUTU",
        "first_name": "PAUL",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2011-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "42565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2011; 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.