Organization Active NPI

Barnett Medical Associates,PC

  • Internal Medicine Physician
  • Mattapan, MA
National Provider Identifier
1174559546
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
59479 Issued in MA
Legal business name
BARNETT MEDICAL ASSOCIATES,PC
Practice address
745 River St
Mattapan, MA 02126-1941
Phone
(617) 364-0222
Fax
(617) 364-3470
NPI assigned
Jun 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Reginald A Barnett, MD
Title
President
Phone
(617) 306-3677

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 59479 MA Primary

Addresses

Primary practice location

745 River St
Mattapan, MA 02126-1941

Mailing address

745 River St
Mattapan, MA 02126-1941
Phone (617) 364-0222

Other identifiers 3

IdentifierTypeStateIssuer
778089OtherMAUSHEALTHCARE
3056597MedicaidMA
65492OtherMAHPHC

National Provider Directory

National Provider Directory

Locations

745 River St
Hyde Park, MA 02136
Phone (617) 364-0222

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1174559546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "745 RIVER ST",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021261941",
            "telephone_number": "617-364-0222",
            "fax_number": "617-364-3470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "745 RIVER ST",
            "city": "MATTAPAN",
            "state": "MA",
            "postal_code": "021261941",
            "telephone_number": "617-364-0222",
            "fax_number": "617-364-3470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARNETT MEDICAL ASSOCIATES,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BARNETT",
        "authorized_official_first_name": "REGINALD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-306-3677",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "59479",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "USHEALTHCARE",
            "identifier": "778089",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3056597",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "65492",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattapan, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.