NPIMap

Organization Active NPI

Mt Auburn Professional Services

  • Emergency Medicine Physician
  • Watertown, MA
National Provider Identifier
1164640306
Registry record updated May 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
Legal business name
MT AUBURN PROFESSIONAL SERVICES
Practice address
One Arsenal Marketplace
Watertown, MA 02472
Phone
(617) 673-1851
Fax
(617) 499-5579
NPI assigned
Apr 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2024

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

Authorized official

Name
Mr. Brian Smith
Title
Cfo
Phone
(405) 245-6238

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207P00000X Primary

Addresses

Primary practice location

One Arsenal Marketplace
Watertown, MA 02472

Mailing address

One Arsenal Marketplace
Watertown, MA 02472
Phone (617) 673-1851

Other identifiers 1

IdentifierTypeStateIssuer
604027OtherMATUFTS GROUP

National Provider Directory

National Provider Directory
Tax ID family
Mt Auburn Prof SVCS Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714867200000",
    "number": "1164640306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE ARSENAL MARKETPLACE",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "02472",
            "telephone_number": "617-673-1851",
            "fax_number": "617-499-5579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE ARSENAL MARKETPLACE",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "02472",
            "telephone_number": "617-673-1851",
            "fax_number": "617-499-5579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT AUBURN PROFESSIONAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2024-05-05",
        "certification_date": "2024-05-05",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "405-245-6238",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Emergency Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS GROUP",
            "identifier": "604027",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2024; 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.