Individual provider Active NPI

Paul N Chervin, MD

  • Neurology with Special Qualifications in Child Neurology Physician
  • Woburn, MA
National Provider Identifier
1396737714
Registry record updated Nov 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X
License
30811 Issued in MA
Practice address
604 Main St
Woburn, MA 01801-2982
Phone
(781) 935-3710
Fax
(781) 935-3410
NPI assigned
Aug 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 30811 MA
Neurology Physician 2084N0400X 30811 MA
Neurology with Special Qualifications in Child Neurology Physician 2084N0402X 30811 MA Primary

Addresses

Primary practice location

604 Main St
Woburn, MA 01801-2982

Mailing address

604 Main St
Woburn, MA 01801
Phone (781) 935-3710

Other identifiers 3

IdentifierTypeStateIssuer
0115142MedicaidMA
11326OtherMAHPIP
701626OtherMATUFTS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040621001709 MA Practitioner - Neurology 1658356944 Practice locations: Woburn, MA

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Duke University School of Medicine, 1967
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

604 Main St
Woburn, MA 01801-2924
Phone (781) 935-3710

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
30811MAMDNeurology with Special Qualifications in Child Neurology Physician

Interoperability endpoints

  • Direct secure messaging: chervin.paul@elincdirect.org

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1124668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415059200000",
    "number": "1396737714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 MAIN ST",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "01801",
            "telephone_number": "781-935-3710",
            "fax_number": "781-935-3410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 MAIN ST",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018012982",
            "telephone_number": "781-935-3710",
            "fax_number": "781-935-3410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHERVIN",
        "first_name": "PAUL",
        "middle_name": "N",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-22",
        "last_updated": "2014-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "30811",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MA",
            "license": "30811",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "MA",
            "license": "30811",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0115142",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPIP",
            "identifier": "11326",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "701626",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

Verify at the official NPI Registry.