Pediatric House Call PC

Primary specialty

SpecialistTaxonomy code 174400000X

License

77664 Issued in MA

Legal business name

PEDIATRIC HOUSE CALL PC

Practice address

56 Winchester St Ste 5
Newton, MA 02461-1730

Phone

(617) 916-5085

Fax

(617) 916-5105

NPI assigned

Mar 26, 2006

Last updated

Apr 29, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Igor Stavitsky, MDNPI 1023094471

Title

Owner

Phone

(617) 916-5085

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Igor Stavitsky, M.D.

  • Emergency Medicine Physician
  • Lawrence, MA
  • NPI 1023094471
  NPD (past) Authorized official
• Ava L. Henderson-Ronchetti, DC

  • Chiropractor
  • Malden, MA
  • NPI 1568467181
  NPD (past)

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

{
    "created_epoch": "1143331200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240963200000",
    "number": "1134189889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 WINCHESTER ST STE 5",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024611730",
            "telephone_number": "617-916-5085",
            "fax_number": "617-916-5105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 WINCHESTER ST STE 5",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024611730",
            "telephone_number": "617-916-5085",
            "fax_number": "617-916-5105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC HOUSE CALL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-26",
        "last_updated": "2009-04-29",
        "status": "A",
        "authorized_official_last_name": "STAVITSKY",
        "authorized_official_first_name": "IGOR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-916-5085",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MA",
            "license": "77664",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3154882",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "A292941",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Pdi Health Ma LLC
• Peak Vision Care Inc.
• Victoria Far Peake, OTR/L
• Kathryn Aa Peck, ATC, CMT
• Meghan Peck
• Pediatric Mental Health of Boston PLLC
• Pediatric Speech Language Services
• Pediatric Weight Management Centers LLC (Great Moves)
• Pediatrics at Newton Wellesley, PC
• Pedodontic Associates of Newton, Inc.

• Specialist in Newton, MA
• Providers in Newton, MA by specialty
• Specialist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2009; 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.