NPIMap

Organization Active NPI

West Cambridge Pediatric & Adolescent Medicin, PC

  • Health Maintenance Organization
  • Cambridge, MA
National Provider Identifier
1487794814
Registry record updated Feb 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
49447 Issued in MA
Legal business name
WEST CAMBRIDGE PEDIATRIC & ADOLESCENT MEDICIN, PC
Practice address
575 Mount Auburn St
Cambridge, MA 02138-4656
Phone
(617) 547-1421
Fax
(617) 492-1118
NPI assigned
Feb 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2022

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

Authorized official

Name
Mrs. Patricia Connors
Title
Office Manager
Phone
(617) 547-1995

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X 49447 MA Primary

Addresses

Primary practice location

575 Mount Auburn St
Cambridge, MA 02138-4656

Mailing address

575 Mount Auburn St
Cambridge, MA 02138-4656
Phone (617) 547-1421

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D0075947West Cambridge Pediatric and Adolescent Medicine575 Mount Auburn St Ste 101, Cambridge, MA 02138Certificate of waiverJul 31, 2027

National Provider Directory

National Provider Directory

Locations

575 Mount Auburn St
Ste 101
Cambridge, MA 02138
Phone (617) 547-1995

575 Mount Auburn St
Cambridge, MA 02138
Phone (617) 491-5586

Practitioners & affiliated clinicians

Practitioners 12

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": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644624000000",
    "number": "1487794814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "575 MOUNT AUBURN ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384656",
            "telephone_number": "617-547-1421",
            "fax_number": "617-492-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 MOUNT AUBURN ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384656",
            "telephone_number": "617-547-1421",
            "fax_number": "617-492-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEST CAMBRIDGE PEDIATRIC & ADOLESCENT MEDICIN, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2022-02-12",
        "certification_date": "2022-02-12",
        "status": "A",
        "authorized_official_last_name": "CONNORS",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "617-547-1995",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "MA",
            "license": "49447",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.