Active NPI
Odette Solla-Cabrera, MD
- Pediatrics Physician
- Marlboro, MA
National Provider Identifier
1407866486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 59542
- Practice address
- 320 Bolton St
Marlboro Pediatrics
Marlboro, MA 01752 - Phone
- (508) 460-9670
- NPI assigned
- Aug 9, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 59542 | MA | Primary |
Addresses
Primary practice location
320 Bolton St
Marlboro Pediatrics
Marlboro, MA 01752
Mailing address
320 Bolton St
Marlboro Pediatrics
Marlboro, MA 01752
Phone (508) 460-9670
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| B10057801 | Other | MA | CIGNA |
| 715661 | Other | MA | TUFTS HMO |
| 3064573 | Medicaid | MA | |
| 20691 | Other | MA | HARVARD PILGRIM |
| J10340 | Other | MA | BLUE CROSS |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160105002711 | MA | Order and Referring Only - Pediatric Medicine | 0941502173 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 59542 | MA | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1309132800000",
"number": "1407866486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "320 BOLTON ST",
"address_2": "MARLBORO PEDIATRICS",
"city": "MARLBORO",
"state": "MA",
"postal_code": "01752",
"telephone_number": "508-460-9670"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "320 BOLTON ST",
"address_2": "MARLBORO PEDIATRICS",
"city": "MARLBORO",
"state": "MA",
"postal_code": "01752",
"telephone_number": "508-460-9670"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOLLA-CABRERA",
"first_name": "ODETTE",
"name_prefix": "Mrs.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-09",
"last_updated": "2011-06-27",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "59542",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "B10057801",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HMO",
"identifier": "715661",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3064573",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "20691",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "J10340",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Marlboro, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.