Active NPI
Mathew H Baldasaro, D.O.
- Pediatrics Physician
- South Yarmouth, MA
National Provider Identifier
1215995162
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 227406
- Practice address
- 237 Station Ave
South Yarmouth, MA 02664-1863 - Phone
- (508) 394-2116
- Fax
- (508) 760-1919
- NPI assigned
- May 2, 2006
- Last updated
- Feb 27, 2008
- 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 |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 227406 | MA | Primary |
Addresses
Primary practice location
237 Station Ave
South Yarmouth, MA 02664-1863
Mailing address
237 Station Ave
South Yarmouth, MA 02664-1863
Phone (508) 394-2116
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 Osteopathy, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 227406 | MA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bass River Pediatric Associates | Past | Accepting new patients |
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/DJIEBD
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Pediatric Hospice and Palliative Medicine Physician
- South Yarmouth, MA
- NPI 1811105539
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146528000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1204070400000",
"number": "1215995162",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "237 STATION AVE",
"city": "SOUTH YARMOUTH",
"state": "MA",
"postal_code": "026641863",
"telephone_number": "508-394-2116",
"fax_number": "508-760-1919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "237 STATION AVE",
"city": "SOUTH YARMOUTH",
"state": "MA",
"postal_code": "026641863",
"telephone_number": "508-394-2116",
"fax_number": "508-760-1919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALDASARO",
"first_name": "MATHEW",
"middle_name": "H",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-02",
"last_updated": "2008-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "227406",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in South Yarmouth, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.