NPIMap

Organization Active NPI

Northeastern University

  • Audiologist
  • Boston, MA
National Provider Identifier
1205066222
Registry record updated Mar 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
4AKD Issued in MA
Legal business name
NORTHEASTERN UNIVERSITY
Practice address
30 Leon St
503 Behrakis Health Sciences Center
Boston, MA 02115-5009
Phone
(617) 373-2492
Fax
(671) 373-8756
NPI assigned
Jul 24, 2009
Last updated
Mar 1, 2012By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTHEASTERN UNIVERSITYAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 1, 2012

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

Authorized official

Name
Mr. Samuel B Solomon
Title
Director of Finance and Treasurer
Phone
(617) 373-2597

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X 4AKD MA Primary
Speech-Language Pathologist 235Z00000X 4AKD MA

Addresses

Primary practice location

30 Leon St
503 Behrakis Health Sciences Center
Boston, MA 02115-5009

Mailing address

30 Leon St
503 Behrakis Health Sciences Center
Boston, MA 02115-5009
Phone (617) 373-2492

Other identifiers 1

IdentifierTypeStateIssuer
03276401OtherMAMEDICARE PTAN

Other names 1

  • Speech-Language and Hearing Center Other name

National Provider Directory

National Provider Directory
Part of
N E Univ Health Service

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1248393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1330560000000",
    "number": "1205066222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 LEON ST",
            "address_2": "503 BEHRAKIS HEALTH SCIENCES CENTER",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155009",
            "telephone_number": "617-373-2492",
            "fax_number": "671-373-8756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 LEON ST",
            "address_2": "503 BEHRAKIS HEALTH SCIENCES CENTER",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155009",
            "telephone_number": "617-373-2492",
            "fax_number": "671-373-8756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEASTERN UNIVERSITY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHEASTERN UNIVERSITY",
        "enumeration_date": "2009-07-24",
        "last_updated": "2012-03-01",
        "status": "A",
        "authorized_official_last_name": "SOLOMON",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE AND TREASURER",
        "authorized_official_telephone_number": "617-373-2597",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "MA",
            "license": "4AKD",
            "primary": true
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "4AKD",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "03276401",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Speech-Language and Hearing Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 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.