Organization Active NPI

Pediattric Medical Care, Inc.

  • Pediatrics Physician
  • Chelsea, MA
National Provider Identifier
1427147909
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATTRIC MEDICAL CARE, INC.
Practice address
1000 Broadway
Chelsea, MA 02150-2247
Phone
(617) 660-6600
Fax
(617) 887-2794
NPI assigned
Oct 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Karen Resnik Godoy, M.D.
Title
Treasurer
Phone
(617) 660-6600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

1000 Broadway
Chelsea, MA 02150-2247

Mailing address

1000 Broadway
Chelsea, MA 02150-2247
Phone (617) 660-6600

Other identifiers 4

IdentifierTypeStateIssuer
998040OtherMANETWORK HEALTH
684849OtherMATUFTS
9786791MedicaidMA
M17428OtherMABLUE SHIELD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1160611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1427147909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 BROADWAY",
            "city": "CHELSEA",
            "state": "MA",
            "postal_code": "021502247",
            "telephone_number": "617-660-6600",
            "fax_number": "617-887-2794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BROADWAY",
            "city": "CHELSEA",
            "state": "MA",
            "postal_code": "021502247",
            "telephone_number": "617-660-6600",
            "fax_number": "617-887-2794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATTRIC MEDICAL CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GODOY",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "RESNIK",
        "authorized_official_title_or_position": "TREASURER",
        "authorized_official_telephone_number": "617-660-6600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH",
            "identifier": "998040",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "684849",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9786791",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "M17428",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chelsea, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.