NPIMap

Organization Active NPI

Pediatric Associates of Medford

  • Pediatrics Physician
  • Medford, MA
National Provider Identifier
1285340323
Registry record updated Jan 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC ASSOCIATES OF MEDFORD
Practice address
101 Main St Ste 201
Medford, MA 02155-4530
Phone
(781) 396-1288
Fax
(781) 391-1989
NPI assigned
Jan 23, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2023

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

Authorized official

Name
Rob Burnett
Title
Practice Manager
Phone
(781) 396-9024

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

101 Main St Ste 201
Medford, MA 02155-4530

Mailing address

101 Main St Ste 201
Medford, MA 02155-4530
Phone (781) 396-1288

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Assoc of Medford2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

101 Main St
Ste 201
Medford, MA 02155
Phone (781) 392-1288

NPI Registry JSON

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

{
    "created_epoch": "1674432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674432000000",
    "number": "1285340323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MAIN ST STE 201",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554530",
            "telephone_number": "781-396-1288",
            "fax_number": "781-391-1989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MAIN ST STE 201",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554530",
            "telephone_number": "781-396-1288",
            "fax_number": "781-391-1989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOCIATES OF MEDFORD",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-23",
        "last_updated": "2023-01-23",
        "certification_date": "2023-01-23",
        "status": "A",
        "authorized_official_last_name": "BURNETT",
        "authorized_official_first_name": "ROB",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "781-396-9024"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2023; 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.