NPIMap

Organization Active NPI

Middlesex Gasteroentology PC

  • Anatomic Pathology & Clinical Pathology Physician
  • Acton, MA
National Provider Identifier
1316424591
Registry record updated Jul 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
MIDDLESEX GASTEROENTOLOGY PC
Practice address
45B Discovery Way
Acton, MA 01720-4482
Phone
(978) 429-2010
Fax
(978) 264-1935
NPI assigned
Jul 20, 2018
Organization subpart
Yes
Parent organization
MIDDLESEX GASTEROENTOLOGY PCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 20, 2018

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

Authorized official

Name
Raj Devarajan, MD
Title
President
Phone
(978) 429-2010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

45B Discovery Way
Acton, MA 01720-4482

Mailing address

45B Discovery Way
Acton, MA 01720-4482
Phone (978) 429-2010

National Provider Directory

National Provider Directory
Tax ID family
Middlesex Gastroenterol2 organizations share this tax ID, including this one
Part of
Middlesex Gastroenterol

Other organizations with this tax ID 1

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

NPI Registry JSON

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

{
    "created_epoch": "1532044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532044800000",
    "number": "1316424591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45B DISCOVERY WAY",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017204482",
            "telephone_number": "978-429-2010",
            "fax_number": "978-264-1935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45B DISCOVERY WAY",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017204482",
            "telephone_number": "978-429-2010",
            "fax_number": "978-264-1935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLESEX GASTEROENTOLOGY PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIDDLESEX GASTEROENTOLOGY PC",
        "enumeration_date": "2018-07-20",
        "last_updated": "2018-07-20",
        "status": "A",
        "authorized_official_last_name": "DEVARAJAN",
        "authorized_official_first_name": "RAJ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-429-2010",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Acton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2018; 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.