South Shore Primary Care PC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

59327 Issued in MA

Legal business name

SOUTH SHORE PRIMARY CARE PC

Practice address

72 Sharpe Street
Suite A10
Hingham, MA 02043

Phone

(781) 331-2010

Fax

(781) 340-9915

NPI assigned

Apr 28, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ravinder S Soondan, MD

Title

President

Phone

(781) 331-2010

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Ravinder Soodan MD Other name

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IGAFBA

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ravinder S Soodan, MD

  • Internal Medicine Physician
  • Hingham, MA
  • NPI 1053488098
  Medicare reassignment NPD

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

{
    "created_epoch": "1146182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1356308712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 295",
            "city": "S WEYMOUTH",
            "state": "MA",
            "postal_code": "02190",
            "telephone_number": "781-331-2010",
            "fax_number": "781-340-9915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 SHARPE STREET",
            "address_2": "SUITE A10",
            "city": "HINGHAM",
            "state": "MA",
            "postal_code": "02043",
            "telephone_number": "781-331-2010",
            "fax_number": "781-340-9915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SHORE PRIMARY CARE PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SOONDAN",
        "authorized_official_first_name": "RAVINDER",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-331-2010",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "59327",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "64627",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9782885",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "M16803",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "614504",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ravinder Soodan MD",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• South Shore Educational Collaborative
• South Shore Hospital
• South Shore Orthopedics LLC
• South Shore Orthopedics, LLC
• South Shore Periodontics LLP
• South Shore Psychiatric and Psychological Associates
• South Shore Psychological Services, LLC
• Anne E Spang, APRN, BC
• Sport and Spine Chiropractic PC
• Magenecka Doudeline St-Hubert

• Internal Medicine Physician in Hingham, MA
• Providers in Hingham, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.