NPIMap

Organization Active NPI

Riverside Nephrology

  • Internal Medicine Physician
  • Lawrence, MA
National Provider Identifier
1417237306
Registry record updated Aug 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
46060 Issued in MA
Legal business name
RIVERSIDE NEPHROLOGY
Practice address
50 Prospect St
Suite301
Lawrence, MA 01841-2841
Phone
(978) 686-4343
Fax
(978) 682-5191
NPI assigned
Aug 23, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2011

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

Authorized official

Name
Eduardo Haddad, MDNPI 1124113022
Title
President
Phone
(978) 686-4343

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 46060 MA Primary

Addresses

Primary practice location

50 Prospect St
Suite301
Lawrence, MA 01841-2841

Mailing address

50 Prospect St
Suite301
Lawrence, MA 01841-2841
Phone (978) 686-4343

National Provider Directory

National Provider Directory
Tax ID family
Riverside Nephrology2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/BGIEBA

Practitioners & affiliated clinicians

Practitioners 2

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": "1314057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314057600000",
    "number": "1417237306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 PROSPECT ST",
            "address_2": "SUITE301",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018412841",
            "telephone_number": "978-686-4343",
            "fax_number": "978-682-5191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 PROSPECT ST",
            "address_2": "SUITE301",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018412841",
            "telephone_number": "978-686-4343",
            "fax_number": "978-682-5191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE NEPHROLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-23",
        "last_updated": "2011-08-23",
        "status": "A",
        "authorized_official_last_name": "HADDAD",
        "authorized_official_first_name": "EDUARDO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-686-4343",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "46060",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2011; 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.