Individual provider Active NPI

Paul A Sergi, MD

  • Surgery Physician
  • Brockton, MA
National Provider Identifier
1316928286
Registry record updated May 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
31915 Issued in MA
Practice address
1 Pearl St
Suite 2700
Brockton, MA 02301-2864
Phone
(508) 584-4104
Fax
(508) 584-4106
NPI assigned
Nov 8, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 31915 MA Primary

Addresses

Primary practice location

1 Pearl St
Suite 2700
Brockton, MA 02301-2864

Mailing address

1 Pearl St
Suite 2700
Brockton, MA 02301-2864
Phone (508) 584-4104

Other identifiers 1

IdentifierTypeStateIssuer
2038757MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050419000289 MA Practitioner - General Surgery 2567400823 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
New York Medical College, 1968
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

211 Park St
Attleboro, MA 02703-3137

Hospital & facility affiliations

  • Sturdy Memorial Hospital Hospital, Attleboro, MA, CCN 220008

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue162
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
31915MAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince Sep 1, 2012 Accepting new patients
Steward Medical Group, Inc CurrentSince Sep 1, 2012 Accepting new patients
Steward Medical Group Inc. Past Accepting new patients
Stewart and Stewart a Medical Corporation Past Accepting new patients

Locations

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

77 Warren St
Fl 5
Brighton, MA 02135
Phone (617) 254-3376

1 Pearl St
Ste 2700
Brockton, MA 02301
Phone (508) 584-4104

2100 Dorchester Ave
Dorchestr Ctr, MA 02124
Phone (617) 506-2222

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

150 York St
Stoughton, MA 02072
Phone (781) 297-1101

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337817600000",
    "number": "1316928286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PEARL ST",
            "address_2": "SUITE 2700",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023012864",
            "telephone_number": "508-584-4104",
            "fax_number": "508-584-4106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PEARL ST",
            "address_2": "SUITE 2700",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023012864",
            "telephone_number": "508-584-4104",
            "fax_number": "508-584-4106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERGI",
        "first_name": "PAUL",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2012-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "31915",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2038757",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.