Bay State Urologists Inc
Organization Active NPI Urology Physician · Watertown, MA
NPI 1114928579 · NPPES record last updated Aug 9, 2023
Key facts
- NPI
- 1114928579
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Urology Physician 208800000X
- Legal business name
- BAY STATE UROLOGISTS INC
- Practice address
- 521 Mount Auburn St Ste 201
Watertown, MA 02472-4153 - Phone
- (617) 926-1200
- Fax
- (617) 926-5195
- NPI assigned
- Aug 9, 2005
- Organization subpart
- No
Authorized official
- Name
- Henry David Mitcheson, MD
- Title
- President
- Phone
- (617) 782-1200
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070921000351 | MA | Part B Supplier - Clinic/Group Practice | 8628162633 |
Receives reassigned benefits from 1 practitioner Practice locations: Watertown, MA |
National Provider Directory
Locations
11 Nevins St
Ste 503
Brighton, MA 02135
Phone (617) 782-1200
521 Mount Auburn St
Ste 201
Watertown, MA 02472
Phone (617) 926-1200
Interoperability endpoints
- https://app.meldrx.com/api/fhir/uc09995_baystateurologistsinc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician |
208800000X | Yes |
Addresses
Primary practice location
521 Mount Auburn St Ste 201
Watertown, MA 02472-4153
Mailing address
521 Mount Auburn St Ste 201
Watertown, MA 02472-4153
Phone (617) 926-1200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9723749 | Medicaid | MA |
Other providers in Watertown, MA
- Olivia Bass
- Leon B Bastajian
- Nisha Ann Basu
- Mark R Bauer
- Edward V. Bauman
- Beaverbrook Step, Inc.
- Margaret Ann Beck
- Carol Becker
- Molly Kate Been
- Joshua Bellini
All providers in Watertown, MA · Urology Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 9, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.