NPIMap

Organization Active NPI

Kenneth K. Tucker, M.D.

  • Cardiovascular Disease Physician
  • Winchester, MA
National Provider Identifier
1326234980
Registry record updated Sep 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
38617 Issued in MA
Legal business name
KENNETH K. TUCKER, M.D.
Practice address
15 Dix St
Suite L
Winchester, MA 01890-1870
Phone
(781) 729-7294
NPI assigned
Sep 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2007

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

Authorized official

Name
Patricia A Langell
Title
Office Manager
Phone
(781) 729-7294

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X 38617 MA Primary

Addresses

Primary practice location

15 Dix St
Suite L
Winchester, MA 01890-1870

Mailing address

15 Dix St
Suite L
Winchester, MA 01890-1870

Other identifiers 4

IdentifierTypeStateIssuer
2069172MedicaidMA
64462OtherHPHC
038617OtherMATUFTS
B54045OtherBCBS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1190073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190073600000",
    "number": "1326234980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 DIX ST",
            "address_2": "SUITE L",
            "city": "WINCHESTER",
            "state": "MA",
            "postal_code": "018901870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 DIX ST",
            "address_2": "SUITE L",
            "city": "WINCHESTER",
            "state": "MA",
            "postal_code": "018901870",
            "telephone_number": "781-729-7294"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENNETH K. TUCKER, M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-18",
        "last_updated": "2007-09-18",
        "status": "A",
        "authorized_official_last_name": "LANGELL",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "781-729-7294"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": "38617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2069172",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "64462",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "038617",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "B54045",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2007; 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.