NPIMap

Organization Active NPI

Twinbrook Surgical Associates

  • Surgery Physician
  • Waltham, MA
National Provider Identifier
1225010846
Registry record updated Jul 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
Legal business name
TWINBROOK SURGICAL ASSOCIATES
Practice address
20 Hope Ave
Ste 207
Waltham, MA 02453-2721
Phone
(781) 893-6520
Fax
(781) 893-6522
NPI assigned
Nov 18, 2005
Last updated
Jul 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2008

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

Authorized official

Name
Thomas Joseph Grady, M DNPI 1518949346
Title
President
Phone
(781) 893-6520

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208600000X Primary
Vascular Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2086S0129X
Colon & Rectal Surgery PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208C00000X

Addresses

Primary practice location

20 Hope Ave
Ste 207
Waltham, MA 02453-2721

Mailing address

20 Hope Ave
Ste 207
Waltham, MA 02453-2721
Phone (781) 893-6520

Other identifiers 2

IdentifierTypeStateIssuer
9701346MedicaidMA
CJ0290OtherMARAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

20 Hope Ave
Ste 207
Waltham, MA 02453
Phone (781) 893-6520

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1132272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217376000000",
    "number": "1225010846",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 HOPE AVE",
            "address_2": "STE 207",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024532721",
            "telephone_number": "781-893-6520",
            "fax_number": "781-893-6522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 HOPE AVE",
            "address_2": "STE 207",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024532721",
            "telephone_number": "781-893-6520",
            "fax_number": "781-893-6522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TWINBROOK SURGICAL ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-18",
        "last_updated": "2008-07-30",
        "status": "A",
        "authorized_official_last_name": "GRADY",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-893-6520",
        "authorized_official_credential": "M D"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Colon & Rectal Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9701346",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CJ0290",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.

Verify at the official NPI Registry.