Active NPI
Charles A Garabedian, M.D.
- Pediatrics Physician
- Concord, MA
National Provider Identifier
1285612101
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 73999
- Practice address
- 86 Baker Ave Extension
Concord Hillside Medical Associates
Concord, MA 01742-2188 - Phone
- (978) 287-9400
- Fax
- (978) 287-9408
- NPI assigned
- Jan 3, 2006
- 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 | 73999 | MA | Primary |
Addresses
Primary practice location
86 Baker Ave Extension
Concord Hillside Medical Associates
Concord, MA 01742-2188
Mailing address
147 Milk St
Provider Enrollment - 9TH Floor
Boston, MA 02109-4806
Phone (617) 559-8104
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4318317 | Other | MA | AETNA |
| J12391 | Other | MA | BLUE CROSS |
| 3089991 | Medicaid | MA | |
| 1202090 | Other | MA | UNITED HEALTHCARE |
| 20981 | Other | MA | HARVARD PILGRIM |
| 073999 | Other | MA | TUFTS |
| 0016156 | Other | MA | NEIGHBOR HOOD HEALTH |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 73999 | MA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1136246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241740800000",
"number": "1285612101",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147 MILK ST",
"address_2": "PROVIDER ENROLLMENT - 9TH FLOOR",
"city": "BOSTON",
"state": "MA",
"postal_code": "021094806",
"telephone_number": "617-559-8104",
"fax_number": "617-421-3487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "86 BAKER AVE EXTENSION",
"address_2": "CONCORD HILLSIDE MEDICAL ASSOCIATES",
"city": "CONCORD",
"state": "MA",
"postal_code": "017422188",
"telephone_number": "978-287-9400",
"fax_number": "978-287-9408"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARABEDIAN",
"first_name": "CHARLES",
"middle_name": "A",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-03",
"last_updated": "2009-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "73999",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "4318317",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "J12391",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3089991",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "1202090",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "20981",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "073999",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBOR HOOD HEALTH",
"identifier": "0016156",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Concord, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.