Active NPI
Andrea Bettacchi Urban, MD
- Pediatrics Physician
- Holliston, MA
National Provider Identifier
1477609295
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 239158
- Practice address
- 100 Jeffrey Avenue
Holliston, MA 01746 - Phone
- (508) 429-2800
- Fax
- (508) 429-7913
- NPI assigned
- Jan 26, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 228340 | MA | |
| Pediatrics Physician | 208000000X | 239158 | MA | Primary |
Addresses
Primary practice location
100 Jeffrey Avenue
Holliston, MA 01746
Mailing address
100 Jeffrey Avenue
Holliston, MA 01746
Phone (508) 429-2800
Other names 1
- Ms. Andrea Bettachi
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 239158 | MA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hollistonpediatric Group | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- aurban8729@direct.chppoc.masshiway.net
Organizations & group practices 1
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.
-
- Pediatrics Physician
- Holliston, MA
- NPI 1538184692
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169769600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1240876800000",
"number": "1477609295",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 JEFFREY AVENUE",
"city": "HOLLISTON",
"state": "MA",
"postal_code": "01746",
"telephone_number": "508-429-2800",
"fax_number": "508-429-7913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 JEFFREY AVENUE",
"city": "HOLLISTON",
"state": "MA",
"postal_code": "01746",
"telephone_number": "508-429-2800",
"fax_number": "508-429-7913"
}
],
"practiceLocations": [],
"basic": {
"last_name": "URBAN",
"first_name": "ANDREA",
"middle_name": "BETTACCHI",
"name_prefix": "Ms.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-26",
"last_updated": "2009-04-28",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "228340",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "239158",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "ANDREA",
"last_name": "BETTACHI",
"prefix": "MS.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Holliston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.