Organization Active NPI

Colden Ear Nose Throat & Allergy LLC

  • Otolaryngology Physician
  • Newburyport, MA
National Provider Identifier
1295786465
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
COLDEN EAR NOSE THROAT & ALLERGY LLC
Practice address
1 Wallace Bashaw Jr. Way
Suite 3002
Newburyport, MA 01950-3875
Phone
(978) 997-1550
Fax
(978) 499-8200
NPI assigned
May 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Authorized official

Name
Crissy L. Olson
Title
Practice MGR.
Phone
(978) 947-1550

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Y00000X Primary
Otolaryngology/Facial Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YX0905X

Addresses

Primary practice location

1 Wallace Bashaw Jr. Way
Suite 3002
Newburyport, MA 01950-3875

Mailing address

1 Wallace Bashaw Jr. Way
Suite 3002
Newburyport, MA 01950-3875
Phone (978) 997-1550

Other identifiers 1

IdentifierTypeStateIssuer
DG8781OtherMARAILROAD MEDICARE

Other names 1

  • COLDEN & SEYMOUR EAR, NOSE, THROAT & ALLERGY Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071127000498 MA Part B Supplier - Clinic/Group Practice 8729177829 Receives reassigned benefits from 7 practitioners
Practice locations: Haverhill, MA; Newburyport, MA

National Provider Directory

National Provider Directory

Locations

24 Morrill Pl
Amesbury, MA 01913
Phone (978) 388-5050

62 Brown St
Ste 301
Haverhill, MA 01830
Phone (978) 374-6770

62 Brown St
Ste 205
Haverhill, MA 01830
Phone (978) 499-3810

1 Wallace Bashaw Way
Ste 3002
Newburyport, MA 01950
Phone (978) 997-1550

200 Sutton St
Ste 100
North Andover, MA 01845
Phone (978) 685-2900

Practitioners & affiliated clinicians

Practitioners 9

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": "1147478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740441600000",
    "number": "1295786465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WALLACE BASHAW JR. WAY",
            "address_2": "SUITE 3002",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "019503875",
            "telephone_number": "978-997-1550",
            "fax_number": "978-499-8200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WALLACE BASHAW JR. WAY",
            "address_2": "SUITE 3002",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "019503875",
            "telephone_number": "978-997-1550",
            "fax_number": "978-499-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLDEN EAR NOSE THROAT & ALLERGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-13",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A",
        "authorized_official_last_name": "OLSON",
        "authorized_official_first_name": "CRISSY",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PRACTICE MGR.",
        "authorized_official_telephone_number": "978-947-1550"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DG8781",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COLDEN & SEYMOUR EAR, NOSE, THROAT & ALLERGY",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Newburyport, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.