Primary Care Clinic Boston PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

PRIMARY CARE CLINIC BOSTON PC

Practice address

2100 Dorchester Ave BLDG Suite314
Dorchester, MA 02124-5615

Phone

(617) 296-0720

Fax

(617) 296-5166

NPI assigned

Dec 13, 2017

Organization subpart

No

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

Authorized official

Name

Ankur A Patel, MDNPI 1932580495

Title

Owner

Phone

(617) 875-5681

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/18145/brand/1/csg/1/fhir/r4

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Ankur Patel, MD

  • Family Medicine Physician
  • Dorchester, MA
  • NPI 1932580495
  Medicare reassignment NPD Authorized official
• Richard Spiro, M.D.

  • Psychiatry Physician
  • Milton, MA
  • NPI 1679510374
  NPD (past)

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

{
    "created_epoch": "1513123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1537747200000",
    "number": "1316452329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 HONEYSUCKLE LN",
            "city": "HANOVER",
            "state": "MA",
            "postal_code": "023393113",
            "telephone_number": "617-875-5681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 DORCHESTER AVE BLDG SUITE314",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021245615",
            "telephone_number": "617-296-0720",
            "fax_number": "617-296-5166"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Dorchester Ave Bldg Suite314",
            "address_purpose": "LOCATION",
            "city": "Dorchester",
            "state": "MA",
            "postal_code": "021245615",
            "country_code": "US",
            "telephone_number": "617-296-0720",
            "fax_number": "617-296-5166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRIMARY CARE CLINIC BOSTON PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-13",
        "last_updated": "2018-09-24",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "ANKUR",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-875-5681",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Praxis Health LLC (Community Health & Rehab Dorchester)
• Brian Pray
• Leanne M Prendergast
• Jerry Preval
• Marlene Price
• Priority Professional Care, LLC
• Professional Consulting and Supervisory Services, LLC
• Psychiatric Home Care Services Inc.
• Isaac Pugh, MSW
• Austin Anthony Puza, PHARM.D.

• Family Medicine Physician in Dorchester, MA
• Providers in Dorchester, MA by specialty
• Family Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2018; 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.