Ambama Clinic PC

Primary specialty

Adolescent Medicine (Internal Medicine) PhysicianTaxonomy code 207RA0000X

License

52194 Issued in MA

Legal business name

AMBAMA CLINIC PC

Practice address

56 Cottage Grove Ave
Brockton, MA 02301-6347

Phone

(617) 296-0720

Fax

(617) 296-5166

NPI assigned

Dec 28, 2006

Last updated

Jan 18, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ashok J Patel, M.D.NPI 1902825441

Title

Manager

Phone

(617) 296-0720

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Locations

Practitioners 1

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.

• Ashok Jivanlal Patel, M.D.

  • Adolescent Medicine (Internal Medicine) Physician
  • Dorchester Center, MA
  • NPI 1902825441
  Authorized official Same address or phone

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200614400000",
    "number": "1205992989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 COTTAGE GROVE AVE",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023016347",
            "telephone_number": "617-296-0720",
            "fax_number": "617-296-5166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 COTTAGE GROVE AVE",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023016347",
            "telephone_number": "617-296-0720",
            "fax_number": "617-296-5166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMBAMA CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-28",
        "last_updated": "2008-01-18",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "ASHOK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "617-296-0720",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RA0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Adolescent Medicine",
            "state": "MA",
            "license": "52194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "697380",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MA",
            "identifier": "M18330",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "0030542",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP",
            "identifier": "DA4008",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9728350",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natalia Sofia Miranda Alves
• Vanessa Alves
• Jared D Amaral
• Raghu R Amaravadi, M.D.
• Tanisha Amazan
• Sandra A Ambrose, NUTRITIONIST
• American Arthritis & Rheumatology Associates Ma PC
• American Diagnsotic Lab., Inc (Feel Well Rehab Clinic)
• American Dream Homecare Agency LLC
• American Prosthetics Inc

• Adolescent Medicine (Internal Medicine) Physician in Brockton, MA
• Providers in Brockton, MA by specialty
• Adolescent Medicine (Internal Medicine) Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.