Organization Active NPI

Rose Ann Berwald, M.D.

  • Gynecology Physician
  • Stoughton, MA
National Provider Identifier
1194077909
Registry record updated Oct 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
70519 Issued in MA
Legal business name
ROSE ANN BERWALD, M.D.
Practice address
966 Park St Ste B2
Stoughton, MA 02072-3650
Phone
(781) 344-7673
Fax
(781) 344-5955
NPI assigned
Oct 4, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2012

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

Authorized official

Name
Rose Ann Berwald, MDNPI 1346208303
Title
Physician
Phone
(781) 344-7673

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
Gynecology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207VG0400X 70519 MA Primary

Addresses

Primary practice location

966 Park St Ste B2
Stoughton, MA 02072-3650

Mailing address

966 Park St Ste B2
Stoughton, MA 02072-3650
Phone (781) 344-7673

Other identifiers 7

IdentifierTypeStateIssuer
070519OtherMATUFTS
32136OtherMAAETNA/US HEALTCARE
B21216OtherMACIGNA
110047284/AMedicaidMA
13564OtherMAHARVARD PILGRIM HEALTHCARE
J08817OtherMABLUE CROSS BLUE SHIELD
3065320OtherMANEIGHBORHOOD HEALTH PLAN

National Provider Directory

National Provider Directory
Tax ID family
Rose Ann Berwald MD2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

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": "1349308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349308800000",
    "number": "1194077909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "966 PARK ST STE B2",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020723650",
            "telephone_number": "781-344-7673",
            "fax_number": "781-344-5955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "966 PARK ST STE B2",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020723650",
            "telephone_number": "781-344-7673",
            "fax_number": "781-344-5955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSE ANN BERWALD, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-04",
        "last_updated": "2012-10-04",
        "status": "A",
        "authorized_official_last_name": "BERWALD",
        "authorized_official_first_name": "ROSE ANN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "781-344-7673",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "MA",
            "license": "70519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "070519",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA/US HEALTCARE",
            "identifier": "32136",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "B21216",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110047284/A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTHCARE",
            "identifier": "13564",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "J08817",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "3065320",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoughton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 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.