NPIMap

Individual provider Active NPI

Christos Katavolos, M.D.

  • Internal Medicine Physician
  • Brockton, MA
National Provider Identifier
1417911611
Registry record updated Jul 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
152259 Issued in MA
Practice address
235 N Pearl St
Brockton, MA 02301-1794
Phone
(508) 427-2335
NPI assigned
Apr 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 152259 MA Primary

Addresses

Primary practice location

235 N Pearl St
Brockton, MA 02301-1794

Mailing address

5410 Maryland Way
Suite 300
Brentwood, TN 37027-5064
Phone (615) 377-5670

Other identifiers 2

IdentifierTypeStateIssuer
2082772MedicaidMA
J27977OtherMABCBS - MA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040903000624 MA Practitioner - HospitalistPractitioner - Internal Medicine 6507832227 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southcoast Physicians Group IncGroup PAC ID 0749171957, 875 clinicians

Practice addresses (Care Compare)

43 High St
Wareham, MA 02571-2097
Phone (508) 973-5919

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
152259MAMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Physicians Group, Inc. CurrentSince Dec 1, 2024 Accepting new patients
Steward Medical Group, Inc CurrentSince Oct 1, 2011 Accepting new patients
Sound Physicians of Massachusetts II PC Internal Medicine CurrentSince Jun 17, 2017 Accepting new patients
Southcoast Physicians Group, Inc. Internal Medicine CurrentSince Dec 1, 2024 Accepting new patients
Sound Physicians of Massachusetts, Inc Internal Medicine CurrentSince Sep 1, 2016 Accepting new patients
Sound Physicians of Massachusetts Inc Internal Medicine CurrentSince Sep 1, 2016 Accepting new patients
Steward Medical Group, Inc CurrentSince Oct 1, 2011 Accepting new patients
Southcoast Hospitals Group, Inc Past Accepting new patients

Locations

200 Groton Rd
Ayer, MA 01432
Phone (978) 784-9000

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

736 Cambridge St
Brighton, MA 02135
Phone (617) 789-2762

235 N Pearl St
Brockton, MA 02301
Phone (508) 427-2525

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

115 Lincoln St
Framingham, MA 01702
Phone (508) 383-1000

575 Beech St
Holyoke, MA 01040
Phone (413) 534-2570

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

800 Washington St
Norwood, MA 02062
Phone (781) 278-6264

43 High St
Wareham, MA 02571
Phone (508) 273-4200

Interoperability endpoints

  • Direct secure messaging: ckatavolos81084@direct.southcoast.org

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1144972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215993600000",
    "number": "1417911611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5410 MARYLAND WAY",
            "address_2": "SUITE 300",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275064",
            "telephone_number": "615-377-5670",
            "fax_number": "615-377-1678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 N PEARL ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011794",
            "telephone_number": "508-427-2335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KATAVOLOS",
        "first_name": "CHRISTOS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-14",
        "last_updated": "2008-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "152259",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2082772",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - MA",
            "identifier": "J27977",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.