Northeast Plastic Surgery, P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

204149 Issued in MA

Legal business name

NORTHEAST PLASTIC SURGERY, P.C.

Practice address

15 Village SQ
Chelmsford, MA 01824-2712

Phone

(978) 256-7697

NPI assigned

Sep 6, 2006

Organization subpart

No

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

Authorized official

Name

Jeffrey D Smith, M.D.

Title

President/Owner

Phone

(978) 256-7697

Specialties & licenses 1

Addresses

Other identifiers 7

Locations

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1586908800000",
    "number": "1154424323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 VILLAGE SQ",
            "city": "CHELMSFORD",
            "state": "MA",
            "postal_code": "018242712",
            "telephone_number": "978-256-7697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 VILLAGE SQ",
            "city": "CHELMSFORD",
            "state": "MA",
            "postal_code": "018242712",
            "telephone_number": "978-256-7697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST PLASTIC SURGERY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2020-04-15",
        "certification_date": "2020-04-15",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "978-256-7697",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MA",
            "license": "204149",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "J22174",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "M21500",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALH",
            "identifier": "22763",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "204149",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3208079",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "50982",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTH",
            "identifier": "21612",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• North St Periodontics PLLC
• North St Periodontics PLLC
• North Star Guidance Center, Inc.
• Northeast Cmop
• Northeast Plastic Surgery
• Sophia Novello
• Bruce Privato Nsubuga
• Ariana Nunez
• Kylie Nuttall
• Josline Nyagahima Thompson, RN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2020; 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.