NPIMap

Organization Active NPI

PBH Professional Group, P.a.

  • Multi-Specialty Clinic/Center
  • Worcester, MA
National Provider Identifier
1457945446
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
PBH PROFESSIONAL GROUP, P.A.
Doing business as
PATH Worcester Professional Group
Practice address
1329 Main St Ste 100
Worcester, MA 01603-1548
Phone
(508) 556-2002
NPI assigned
Feb 22, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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

Authorized official

Name
Flora F. Sadri-Azarbayejani, D.O.
Title
President and Secretary
Phone
(615) 308-7871

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

1329 Main St Ste 100
Worcester, MA 01603-1548

Mailing address

103 Powell CT Ste 100
Brentwood, TN 37027-5050
Phone (615) 308-7871

Other practice location 1

1398 Main St Ste 200
Worcester, MA 01603-1524
Phone (508) 834-8599

Other practice location 2

1183 Main St Ste 100
Worcester, MA 01603-2012
Phone (508) 834-5999

Other names 1

  • PATH Worcester Professional Group Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Path 5Palms Professional Group5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

1329 Main St
Ste 100
Worcester, MA 01603
Phone (508) 556-2002

1398 Main St
Ste 200
Worcester, MA 01603
Phone (508) 834-8599

NPI Registry JSON

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

{
    "created_epoch": "1613952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1613952000000",
    "number": "1457945446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 POWELL CT STE 100",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370275050",
            "telephone_number": "615-308-7871",
            "fax_number": "615-261-8901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1329 MAIN ST STE 100",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016031548",
            "telephone_number": "508-556-2002"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1398 Main St Ste 200",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016031524",
            "country_code": "US",
            "telephone_number": "508-834-8599",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1183 Main St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016032012",
            "country_code": "US",
            "telephone_number": "508-834-5999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PBH PROFESSIONAL GROUP, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-22",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A",
        "authorized_official_last_name": "SADRI-AZARBAYEJANI",
        "authorized_official_first_name": "FLORA",
        "authorized_official_middle_name": "F.",
        "authorized_official_title_or_position": "PRESIDENT AND SECRETARY",
        "authorized_official_telephone_number": "615-308-7871",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PATH Worcester Professional Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2021; 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.