NPIMap

Organization Active NPI

Gastrointestinal Specialists, LLC

  • Gastroenterology Physician
  • Brockton, MA
National Provider Identifier
1386694149
Registry record updated Apr 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
GASTROINTESTINAL SPECIALISTS, LLC
Practice address
189 Quincy St
Brockton, MA 02302-2926
Phone
(508) 588-6700
Fax
(508) 584-3010
NPI assigned
May 11, 2006
Last updated
Apr 2, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2019

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

Authorized official

Name
Jerry S Stern, M.D.NPI 1467477794
Title
President
Phone
(508) 588-6700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X NU Primary

Addresses

Primary practice location

189 Quincy St
Brockton, MA 02302-2926

Mailing address

189 Quincy St
Brockton, MA 02302-2926
Phone (508) 588-6700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050802000466 MA Part B Supplier - Clinic/Group Practice 9638107451 Receives reassigned benefits from 16 practitioners
Practice locations: Brockton, MA; East Bridgewater, MA; Taunton, MA

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

110 Liberty St
Ste 2B
Brockton, MA 02301
Phone (508) 588-6700

1 Donalds Way
Ste 203
East Bridgewater, MA 02333
Phone (508) 350-2940

35 Summer St
Ste 201
Taunton, MA 02780
Phone (508) 821-4100

Practitioners & affiliated clinicians

Practitioners 18

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.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1147305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1554163200000",
    "number": "1386694149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "189 QUINCY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023022926",
            "telephone_number": "508-588-6700",
            "fax_number": "508-584-3010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "189 QUINCY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023022926",
            "telephone_number": "508-588-6700",
            "fax_number": "508-584-3010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GASTROINTESTINAL SPECIALISTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-11",
        "last_updated": "2019-04-02",
        "status": "A",
        "authorized_official_last_name": "STERN",
        "authorized_official_first_name": "JERRY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-588-6700",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 2, 2019; 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.