NPIMap

Organization Active NPI

Northeast Foot & Ankle Specialists, P.C.

  • Podiatrist
  • Tewksbury, MA
National Provider Identifier
1447376017
Registry record updated Nov 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
2042 Issued in MA
Legal business name
NORTHEAST FOOT & ANKLE SPECIALISTS, P.C.
Practice address
1565 Main St Ste 102
Tewksbury, MA 01876-4735
Phone
(978) 640-1010
Fax
(978) 640-9444
NPI assigned
Mar 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2011

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

Authorized official

Name
Peter Bregman, DPMNPI 1235165671
Title
President
Phone
(978) 640-1010

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213E00000X 2042 MA Primary
PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213E00000X 0308 NH
PodiatristGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 213E00000X 1432 MA

Addresses

Primary practice location

1565 Main St Ste 102
Tewksbury, MA 01876-4735

Mailing address

1565 Main St Ste 102
Tewksbury, MA 01876-4735
Phone (978) 640-1010

Other identifiers 1

IdentifierTypeStateIssuer
480030479OtherMARAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

1565 Main St
Ste 102
Tewksbury, MA 01876
Phone (978) 274-4100

11 Middlesex Ave
Unit 5
Wilmington, MA 01887
Phone (508) 658-9774

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": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320192000000",
    "number": "1447376017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1565 MAIN ST STE 102",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018764735",
            "telephone_number": "978-640-1010",
            "fax_number": "978-640-9444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1565 MAIN ST STE 102",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018764735",
            "telephone_number": "978-640-1010",
            "fax_number": "978-640-9444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST FOOT & ANKLE SPECIALISTS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2011-11-02",
        "status": "A",
        "authorized_official_last_name": "BREGMAN",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-640-1010",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "MA",
            "license": "2042",
            "primary": true
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "NH",
            "license": "0308",
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": "MA",
            "license": "1432",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "480030479",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tewksbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 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.