David S Titelbaum, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

54043 Issued in MA

Practice address

265 Westgate Dr
Brockton, MA 02301-1817

Phone

(800) 258-4674

Fax

(508) 897-3198

NPI assigned

Jul 6, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Shields Radiology Associates

  • Diagnostic Radiology Physician
  • Natick, MA
  • NPI 1518913805
  Medicare reassignment NPD

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

{
    "created_epoch": "1120608000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513036800000",
    "number": "1225035264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 WESTGATE DR",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011817",
            "telephone_number": "800-258-4674",
            "fax_number": "508-897-3198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "265 WESTGATE DR",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011817",
            "telephone_number": "800-258-4674",
            "fax_number": "508-897-3198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TITELBAUM",
        "first_name": "DAVID",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-06",
        "last_updated": "2017-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "MA",
            "license": "54043",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "OH",
            "license": "3585828",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "54043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "J08231",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3045951",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Margaret Mary Tiberio
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• Brianna Marie Tilley
• Regina Tillman-Smith
• Tilton Psychiatric Services, PLLC
• Toni Titus
• Tjocelyne Counseling & Consulting LLC
• Tjocelyne Counseling & Consulting LLC.
• To-Shankel Healthcare Services LLC
• Alvin To

• Diagnostic Radiology Physician in Brockton, MA
• Providers in Brockton, MA by specialty
• Diagnostic Radiology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.