Active NPI
Ann Nicoloff Becker, MD
- Pediatric Adolescent Medicine Physician
- Wellesley, MA
National Provider Identifier
1194791863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Adolescent Medicine Physician
- License
- 73532
- Practice address
- 332 Washington St
Suite 275
Wellesley, MA 02481-6219 - Phone
- (781) 235-7730
- NPI assigned
- Feb 23, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | 73532 | MA | Primary |
Addresses
Primary practice location
332 Washington St
Suite 275
Wellesley, MA 02481-6219
Mailing address
1227 High St
Westwood, MA 02090-2764
Phone (781) 255-5963
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3147185 | Medicaid | MA |
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 |
|---|---|---|---|
| 73532 | MA | MD | Pediatric Adolescent Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ann Nicoloff Becker, MD, LLC | Adolescent Medicine | Past | Accepting new patients |
Interoperability endpoints
- abecker7330@direct.chppoc.masshiway.net
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Pediatric Adolescent Medicine Physician
- Wellesley, MA
- NPI 1285829887
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1189036800000",
"number": "1194791863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1227 HIGH ST",
"city": "WESTWOOD",
"state": "MA",
"postal_code": "020902764",
"telephone_number": "781-255-5963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "332 WASHINGTON ST",
"address_2": "SUITE 275",
"city": "WELLESLEY",
"state": "MA",
"postal_code": "024816219",
"telephone_number": "781-235-7730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BECKER",
"first_name": "ANN",
"middle_name": "NICOLOFF",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-02-23",
"last_updated": "2007-09-06",
"status": "A"
},
"taxonomies": [
{
"code": "2080A0000X",
"taxonomy_group": "",
"desc": "Pediatrics, Adolescent Medicine",
"state": "MA",
"license": "73532",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3147185",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Wellesley, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.