Minimally Invasive Podiatry LLC

Primary specialty

Foot Surgery PodiatristTaxonomy code 213ES0131X

Legal business name

MINIMALLY INVASIVE PODIATRY LLC

Practice address

322 Pearl Street
Ste 1
Cambridge, MA 02139-4762

Phone

(267) 230-3629

NPI assigned

Mar 2, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Quinn Taylor Charbonneau, DPMNPI 1144541327

Title

Physician/Owner

Phone

(267) 230-3629

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Quinn T Charbonneau, DPM

  • Podiatrist
  • Winthrop, MA
  • NPI 1144541327
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1646179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649203200000",
    "number": "1396492104",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "322 PEARL STREET",
            "address_2": "SUITE 1",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021394762",
            "telephone_number": "267-230-3629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "322 PEARL STREET",
            "address_2": "STE 1",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021394762",
            "telephone_number": "267-230-3629"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "480 Maple St",
            "address_purpose": "LOCATION",
            "city": "Danvers",
            "state": "MA",
            "postal_code": "019234065",
            "country_code": "US",
            "telephone_number": "978-304-8475",
            "fax_number": "978-304-8015",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "298 Washington Street",
            "address_2": "4th Floor",
            "address_purpose": "LOCATION",
            "city": "Gloucester",
            "state": "MA",
            "postal_code": "019304832",
            "country_code": "US",
            "telephone_number": "267-230-3629",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MINIMALLY INVASIVE PODIATRY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-02",
        "last_updated": "2022-04-06",
        "certification_date": "2022-04-06",
        "status": "A",
        "authorized_official_last_name": "CHARBONNEAU",
        "authorized_official_first_name": "QUINN",
        "authorized_official_middle_name": "TAYLOR",
        "authorized_official_title_or_position": "PHYSICIAN/OWNER",
        "authorized_official_telephone_number": "267-230-3629",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213ES0131X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Foot Surgery Podiatrist in Cambridge, MA
• Providers in Cambridge, MA by specialty
• Foot Surgery Podiatrist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2022; 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.