NPIMap

Organization Active NPI

Boston Facial Plastic Surgery, P.C.

  • Specialist
  • Quincy, MA
National Provider Identifier
1386812840
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
150911 Issued in MA
Legal business name
BOSTON FACIAL PLASTIC SURGERY, P.C.
Practice address
500 Congress St
Suite 2a
Quincy, MA 02169-0908
Phone
(617) 472-3137
Fax
(617) 472-1012
NPI assigned
Feb 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

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

Authorized official

Name
Raffi Der Sarkissian, MD
Title
President
Phone
(617) 472-3137

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 150911 MA Primary

Addresses

Primary practice location

500 Congress St
Suite 2a
Quincy, MA 02169-0908

Mailing address

1686 Washington St
Boston, MA 02118-3383
Phone (617) 927-0037

Other identifiers 2

IdentifierTypeStateIssuer
3152391MedicaidMA
M18940OtherMABLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

500 Congress St
Ste 2A
Quincy, MA 02169
Phone (617) 376-8840

Practitioners & affiliated clinicians

Practitioners 3

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": "1203292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562803200000",
    "number": "1386812840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1686 WASHINGTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021183383",
            "telephone_number": "617-927-0037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 CONGRESS ST",
            "address_2": "SUITE 2A",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021690908",
            "telephone_number": "617-472-3137",
            "fax_number": "617-472-1012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON FACIAL PLASTIC SURGERY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-18",
        "last_updated": "2019-07-11",
        "status": "A",
        "authorized_official_last_name": "DER SARKISSIAN",
        "authorized_official_first_name": "RAFFI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-472-3137",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MA",
            "license": "150911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3152391",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "M18940",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2019; 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.