Organization Active NPI

Ann Nicoloff Becker, MD, LLC

  • Pediatric Adolescent Medicine Physician
  • Wellesley, MA
National Provider Identifier
1285829887
Registry record updated Sep 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
License
73532 Issued in MA
Legal business name
ANN NICOLOFF BECKER, MD, LLC
Practice address
332 Washington St
Suite 275
Wellesley, MA 02481-6219
Phone
(781) 235-7730
Fax
(781) 235-7739
NPI assigned
Sep 7, 2007
Last updated
Sep 7, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2007

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

Authorized official

Name
Ann Nicoloff Becker, MDNPI 1194791863
Title
Owner
Phone
(781) 235-7730

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 73532 MA Primary

Addresses

Primary practice location

332 Washington St
Suite 275
Wellesley, MA 02481-6219

Mailing address

332 Washington Street
Suite 275
Wellesley, MA 02481-6204
Phone (781) 235-7730

Other identifiers 1

IdentifierTypeStateIssuer
9744550MedicaidMA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D1046048Ann Nicoloff Becker MD332 Washington Street 2ND Floor Suite 275, Wellesley Hills, MA 02481Certificate of waiverSep 28, 2027

National Provider Directory

National Provider Directory

Locations

332 Washington St
Ste 275
Wellesley Hls, MA 02481
Phone (781) 235-7730

Practitioners & affiliated clinicians

Practitioners 3

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": "1189123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189123200000",
    "number": "1285829887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "332 WASHINGTON STREET",
            "address_2": "SUITE 275",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024816204",
            "telephone_number": "781-235-7730",
            "fax_number": "781-235-7739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 WASHINGTON ST",
            "address_2": "SUITE 275",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024816219",
            "telephone_number": "781-235-7730",
            "fax_number": "781-235-7739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANN NICOLOFF BECKER, MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-07",
        "last_updated": "2007-09-07",
        "status": "A",
        "authorized_official_last_name": "BECKER",
        "authorized_official_first_name": "ANN",
        "authorized_official_middle_name": "NICOLOFF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-235-7730",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MA",
            "license": "73532",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9744550",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellesley, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.