NPIMap

Organization Active NPI

Asthma & Allergy Physicians LLC

  • Allergy Physician
  • Brockton, MA
National Provider Identifier
1376586354
Registry record updated Apr 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy PhysicianTaxonomy code 207KA0200X
License
30943 Issued in MA
Legal business name
ASTHMA & ALLERGY PHYSICIANS LLC
Practice address
35 Pearl Street
Suite 300
Brockton, MA 02301
Phone
(508) 584-6300
Fax
(508) 580-4664
NPI assigned
Jun 14, 2006
Last updated
Apr 28, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2023

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

Authorized official

Name
Mary Lou Hansen
Title
Office Manager
Phone
(508) 584-6300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy Physician 207KA0200X 30943 MA Primary

Addresses

Primary practice location

35 Pearl Street
Suite 300
Brockton, MA 02301

Mailing address

35 Pearl Street
Suite 300
Brockton, MA 02301
Phone (508) 584-6300

Other practice location 1

675 Paramount Dr Ste 303
Raynham, MA 02767-5416
Phone (508) 822-4100

Other practice location 2

115 Water St
Milford, MA 01757-3015
Phone (508) 634-8700

Other identifiers 1

IdentifierTypeStateIssuer
9729470MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050602000741 MA Part B Supplier - Clinic/Group Practice 7012950801 Receives reassigned benefits from 8 practitioners
Practice locations: Brockton, MA; Milford, MA; Raynham, MA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D0080406Asthma & Allergy Physicians, LLC35 Pearl St, Suite 300, Brockton, MA 02301Certificate of waiverOct 26, 2027
22D0687776Asthma & Allergy Physicians, LLC115 Water St, Milford, MA 01757Certificate of waiverOct 26, 2027
22D0945402Asthma & Allergy Physicians, LLC675 Paramount Drive, Raynham, MA 02767Certificate of waiverOct 26, 2027

National Provider Directory

National Provider Directory

Locations

35 Pearl St
Ste 300
Brockton, MA 02301
Phone (508) 584-6300

115 Water St
Milford, MA 01757
Phone (508) 634-8700

675 Paramount Dr
Ste 303
Raynham, MA 02767
Phone (508) 259-3268

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1682640000000",
    "number": "1376586354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 PEARL STREET",
            "address_2": "SUITE 300",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "02301",
            "telephone_number": "508-584-6300",
            "fax_number": "508-580-4664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 PEARL STREET",
            "address_2": "SUITE 300",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "02301",
            "telephone_number": "508-584-6300",
            "fax_number": "508-580-4664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "675 Paramount Dr Ste 303",
            "address_purpose": "LOCATION",
            "city": "Raynham",
            "state": "MA",
            "postal_code": "027675416",
            "country_code": "US",
            "telephone_number": "508-822-4100",
            "fax_number": "508-823-9363",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 Water St",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "MA",
            "postal_code": "017573015",
            "country_code": "US",
            "telephone_number": "508-634-8700",
            "fax_number": "508-634-8311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ASTHMA & ALLERGY PHYSICIANS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-14",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A",
        "authorized_official_last_name": "HANSEN",
        "authorized_official_first_name": "MARY LOU",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "508-584-6300"
    },
    "taxonomies": [
        {
            "code": "207KA0200X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology, Allergy",
            "state": "MA",
            "license": "30943",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9729470",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.