Individual provider Active NPI

Susan T Cabot, MD

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1124037601
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
80138 Issued in MA
Practice address
780 Boylston St
Medical Care Affiliates
Boston, MA 02199-7820
Phone
(617) 262-1500
Fax
(617) 262-7015
NPI assigned
Aug 5, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 80138 MA Primary

Addresses

Primary practice location

780 Boylston St
Medical Care Affiliates
Boston, MA 02199-7820

Mailing address

780 Boylston St
Medical Care Affiliates
Boston, MA 02199-7820
Phone (617) 262-1500

Other identifiers 1

IdentifierTypeStateIssuer
3150577MedicaidMA

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
80138MAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124037601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "780 BOYLSTON ST",
            "address_2": "MEDICAL CARE AFFILIATES",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021997820",
            "telephone_number": "617-262-1500",
            "fax_number": "617-262-7015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 BOYLSTON ST",
            "address_2": "MEDICAL CARE AFFILIATES",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021997820",
            "telephone_number": "617-262-1500",
            "fax_number": "617-262-7015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CABOT",
        "first_name": "SUSAN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "80138",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3150577",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, 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.

Verify at the official NPI Registry.