Organization Active NPI

Peter E Masucci, MD, PC

  • Pediatrics Physician
  • Everett, MA
National Provider Identifier
1164479002
Registry record updated Feb 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PETER E MASUCCI, MD, PC
Practice address
391 Broadway
Suite 301
Everett, MA 02149-3470
Phone
(617) 389-2121
NPI assigned
May 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2012

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

Authorized official

Name
Dr. Peter E Masucci, MD
Title
President
Phone
(617) 389-2121

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

391 Broadway
Suite 301
Everett, MA 02149-3470

Mailing address

391 Broadway
Suite 301
Everett, MA 02149-3470
Phone (617) 389-2121

Other identifiers 1

IdentifierTypeStateIssuer
9717412MedicaidMA

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/483/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

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": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329091200000",
    "number": "1164479002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "391 BROADWAY",
            "address_2": "SUITE 301",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021493470",
            "telephone_number": "617-389-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "391 BROADWAY",
            "address_2": "SUITE 301",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021493470",
            "telephone_number": "617-389-2121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER E MASUCCI, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2012-02-13",
        "status": "A",
        "authorized_official_last_name": "MASUCCI",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-389-2121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9717412",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2012; 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.