Individual provider Active NPI

Patrick Treanor, CCP

  • Perfusionist
  • Dedham, MA
National Provider Identifier
1366862880
Registry record updated Apr 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PerfusionistTaxonomy code 242T00000X
License
PL27 Issued in MA
Practice address
370 Washington St
Dedham, MA 02026-1871
Phone
(781) 461-1376
NPI assigned
Apr 23, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Perfusionist 242T00000X PL27 MA Primary

Addresses

Primary practice location

370 Washington St
Dedham, MA 02026-1871

Mailing address

370 Washington St
Dedham, MA 02026-1871
Phone (781) 461-1376

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PL27MAMDPerfusionist

NPI Registry JSON

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

{
    "created_epoch": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398211200000",
    "number": "1366862880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 WASHINGTON ST",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020261871",
            "telephone_number": "781-461-1376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "370 WASHINGTON ST",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "020261871",
            "telephone_number": "781-461-1376"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREANOR",
        "first_name": "PATRICK",
        "name_prefix": "Mr.",
        "credential": "CCP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-23",
        "last_updated": "2014-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "242T00000X",
            "taxonomy_group": "",
            "desc": "Perfusionist",
            "state": "MA",
            "license": "PL27",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dedham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2014; 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.