NPIMap

Organization Active NPI

Patriot Urgent Care Professionals, PC

Doing business as Doctors Express

  • Urgent Care Clinic/Center
  • Waltham, MA
National Provider Identifier
1417205105
Registry record updated Aug 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
PATRIOT URGENT CARE PROFESSIONALS, PC
Doing business as
Doctors Express
Practice address
1030 Main Street
Waltham, MA 02451
Phone
(781) 894-6900
NPI assigned
Aug 28, 2012
Last updated
Aug 28, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2012

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

Authorized official

Name
Mr. David G Adams
Title
Secretary
Phone
(617) 459-5100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

1030 Main Street
Waltham, MA 02451

Mailing address

39 Bretton Rd
Dover, MA 02030-2505

Other names 1

  • Doctors Express Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121030000548 MA Part B Supplier - Clinic/Group Practice 8820248784 Receives reassigned benefits from 93 practitioners
16 other NPIs on this enrollment
Practice locations: Waltham, MA; Stoneham, MA; North Andover, MA; Cambridge, MA; Methuen, MA; Medford, MA; Franklin, MA; Chestnut Hill, MA…

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 93

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 93

NPI Registry JSON

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346112000000",
    "number": "1417205105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 BRETTON RD",
            "city": "DOVER",
            "state": "MA",
            "postal_code": "020302505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 MAIN STREET",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "02451",
            "telephone_number": "781-894-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRIOT URGENT CARE PROFESSIONALS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-28",
        "last_updated": "2012-08-28",
        "status": "A",
        "authorized_official_last_name": "ADAMS",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "SECRETARY",
        "authorized_official_telephone_number": "617-459-5100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Doctors Express",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Waltham, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; 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.