Organization Active NPI

Plastic Surgical Associates, Inc.

  • Specialist
  • Newton Lower Falls, MA
National Provider Identifier
1154450286
Registry record updated Jan 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
36527 Issued in MA
Legal business name
PLASTIC SURGICAL ASSOCIATES, INC.
Practice address
2000 Washington St Ste 444
Newton Lower Falls, MA 02462-1608
Phone
(617) 244-0990
Fax
(617) 969-4044
NPI assigned
Mar 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2009

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

Authorized official

Name
Dr. Matthias B. Donelan, MD
Title
President
Phone
(617) 244-0990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 36527 MA Primary

Addresses

Primary practice location

2000 Washington St Ste 444
Newton Lower Falls, MA 02462-1608

Mailing address

2000 Washington St Ste 444
Newton Lower Falls, MA 02462-1608
Phone (617) 244-0990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081204000447 MA Part B Supplier - Clinic/Group Practice 0749341105 Receives reassigned benefits from 2 practitioners
Practice locations: Newton, MA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1231200000000",
    "number": "1154450286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 WASHINGTON ST STE 444",
            "city": "NEWTON LOWER FALLS",
            "state": "MA",
            "postal_code": "024621608",
            "telephone_number": "617-244-0990",
            "fax_number": "617-969-4044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 WASHINGTON ST STE 444",
            "city": "NEWTON LOWER FALLS",
            "state": "MA",
            "postal_code": "024621608",
            "telephone_number": "617-244-0990",
            "fax_number": "617-969-4044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLASTIC SURGICAL ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2009-01-06",
        "status": "A",
        "authorized_official_last_name": "DONELAN",
        "authorized_official_first_name": "MATTHIAS",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-244-0990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MA",
            "license": "36527",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton Lower Falls, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.