Active NPI
Earton C Robertson, M.D.
- Pediatrics Physician
- Woburn, MA
National Provider Identifier
1174586176
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 31789
- Practice address
- 7 Alfred St
Baldwin Park II
Woburn, MA 01801-1976 - Phone
- (781) 933-6236
- Fax
- (781) 938-8050
- NPI assigned
- Apr 10, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 31789 | MA | Primary |
Addresses
Primary practice location
7 Alfred St
Baldwin Park II
Woburn, MA 01801-1976
Mailing address
7 Alfred St
Baldwin Park II
Woburn, MA 01801-1976
Phone (781) 933-6236
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 20190 | Other | MA | HARVARD COMMUNITY HEALTH |
| B54028 | Other | MA | BLUE CROSS BLUE SHIELD |
| 2081652 | Medicaid | MA | |
| 0006454001 | Other | MA | CIGNA |
| 031789 | Other | MA | TUFTS HEALTH PLAN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 31789 | MA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256860800000",
"number": "1174586176",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 ALFRED ST",
"address_2": "BALDWIN PARK II",
"city": "WOBURN",
"state": "MA",
"postal_code": "018011976",
"telephone_number": "781-933-6236",
"fax_number": "781-938-8050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7 ALFRED ST",
"address_2": "BALDWIN PARK II",
"city": "WOBURN",
"state": "MA",
"postal_code": "018011976",
"telephone_number": "781-933-6236",
"fax_number": "781-938-8050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ROBERTSON",
"first_name": "EARTON",
"middle_name": "C",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-10",
"last_updated": "2009-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "31789",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD COMMUNITY HEALTH",
"identifier": "20190",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "B54028",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2081652",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "0006454001",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH PLAN",
"identifier": "031789",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Woburn, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.