Organization Active NPI

Medfield Internal Medicine, PLLC

  • Internal Medicine Physician
  • Medfield, MA
National Provider Identifier
1174364723
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
MEDFIELD INTERNAL MEDICINE, PLLC
Practice address
266 Main St Ste 4
Medfield, MA 02052-2018
Phone
(508) 359-8141
Fax
(508) 359-8005
NPI assigned
Jun 5, 2024
Last updated
Oct 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Authorized official

Name
Russell E Kling, MDNPI 1497168983
Title
Physician/Owner
Phone
(508) 359-8141

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X Primary

Addresses

Primary practice location

266 Main St Ste 4
Medfield, MA 02052-2018

Mailing address

266 Main St Ste 4
Medfield, MA 02052-2018
Phone (508) 359-8141

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241111002624 MA Part B Supplier - Clinic/Group Practice 0749714947 Receives reassigned benefits from 4 practitioners
Practice locations: Medfield, MA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D0074096Medfield Internal Medicine266 Main Street, Medfield, MA 02052AccreditationDec 22, 2027

National Provider Directory

National Provider Directory

Locations

266 Main St
Ste 1
Medfield, MA 02052

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1717545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727827200000",
    "number": "1174364723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "266 MAIN ST STE 4",
            "city": "MEDFIELD",
            "state": "MA",
            "postal_code": "020522018",
            "telephone_number": "508-359-8141",
            "fax_number": "508-359-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "266 MAIN ST STE 4",
            "city": "MEDFIELD",
            "state": "MA",
            "postal_code": "020522018",
            "telephone_number": "508-359-8141",
            "fax_number": "508-359-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDFIELD INTERNAL MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-05",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A",
        "authorized_official_last_name": "KLING",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "508-359-8141",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.