Active NPI
Richard L Paulson, M.D.
- Surgery Physician
- Brockton, MA
National Provider Identifier
1194794875
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 48940
- Practice address
- 1 Pearl Street
Suite 2700
Brockton, MA 02301-2870 - Phone
- (508) 584-4104
- Fax
- (508) 584-4105
- NPI assigned
- Mar 16, 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 48940 | MA | Primary |
Addresses
Primary practice location
1 Pearl Street
Suite 2700
Brockton, MA 02301-2870
Mailing address
1 Pearl Street
Suite 2700
Brockton, MA 02301-2870
Phone (508) 584-4104
Other identifiers 8
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11925340 | Other | MA | HEALTHNET |
| 3008525 | Medicaid | MA | |
| 48940 | Other | MA | TUFTS |
| P00118211 | Other | MA | RR MEDICARE |
| PAJ04420 | Other | MA | BLUE CROSS/BLUE SHIELD |
| 8202 | Other | MA | HARVARD PILGRIM |
| 0011428 | Other | MA | NEIGHBORHOOD HEALTH |
| 17-00325 | Other | MA | AETNA |
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)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1142467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263427200000",
"number": "1194794875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 PEARL STREET",
"address_2": "SUITE 2700",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023012870",
"telephone_number": "508-584-4104",
"fax_number": "508-584-4105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 PEARL STREET",
"address_2": "SUITE 2700",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023012870",
"telephone_number": "508-584-4104",
"fax_number": "508-584-4105"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PAULSON",
"first_name": "RICHARD",
"middle_name": "L",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-03-16",
"last_updated": "2010-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MA",
"license": "48940",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HEALTHNET",
"identifier": "11925340",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3008525",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "48940",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR MEDICARE",
"identifier": "P00118211",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "PAJ04420",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "8202",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBORHOOD HEALTH",
"identifier": "0011428",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "17-00325",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.