NPIMap

Organization Active NPI

Faculty Practice Foundation , Evans Medical Foundation

Doing business as The Endoscopy Center of Brookline

  • Ambulatory Surgical Clinic/Center
  • Boston, MA
National Provider Identifier
1326179532
Registry record updated Jun 15, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
Legal business name
FACULTY PRACTICE FOUNDATION , EVANS MEDICAL FOUNDATION
Doing business as
The Endoscopy Center of Brookline
Practice address
930 Commonwealth Ave
Boston, MA 02215-1274
Phone
(617) 414-6600
Fax
(617) 414-6601
NPI assigned
Mar 8, 2007
Last updated
Jun 15, 2011By the provider in NPPES
Organization subpart
Yes
Parent organization
EVANS MEDICAL FOUNDATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 15, 2011

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

Authorized official

Name
Mrs. Annmarie Cloonan
Title
Director
Phone
(617) 638-7231

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X NU Primary

Addresses

Primary practice location

930 Commonwealth Ave
Boston, MA 02215-1274

Mailing address

930 Commonwealth Ave
Boston, MA 02215-1274
Phone (617) 414-6600

Other identifiers 6

IdentifierTypeStateIssuer
5624667OtherMAFIRST HEALTH
623859OtherMATUFTS HEALTH PLAN
1320705OtherMACIGNA
0035384OtherMANHP
3700270OtherMAAETNA
M88035OtherMABLUE CROSS BLUE SHIELD

Other names 1

  • The Endoscopy Center of Brookline Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Evans Medical Foundation Inc3 organizations share this tax ID, including this one
Part of
Evans Medical Foundation Inc

Other organizations with this tax ID 2

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

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

{
    "created_epoch": "1173312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308096000000",
    "number": "1326179532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 COMMONWEALTH AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022151274",
            "telephone_number": "617-414-6600",
            "fax_number": "617-414-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 COMMONWEALTH AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022151274",
            "telephone_number": "617-414-6600",
            "fax_number": "617-414-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FACULTY PRACTICE FOUNDATION , EVANS MEDICAL FOUNDATION",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EVANS MEDICAL FOUNDATION",
        "enumeration_date": "2007-03-08",
        "last_updated": "2011-06-15",
        "status": "A",
        "authorized_official_last_name": "CLOONAN",
        "authorized_official_first_name": "ANNMARIE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "617-638-7231",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "5624667",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "623859",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1320705",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHP",
            "identifier": "0035384",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3700270",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "M88035",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Endoscopy Center of Brookline",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2011; 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.