Sandwich Pediatrics

Primary specialty

Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X

License

50001 Issued in MA

Legal business name

SANDWICH PEDIATRICS

Practice address

449 Route 130
Sandwich, MA 02563-2339

Phone

(508) 888-8430

Fax

(508) 888-6673

NPI assigned

May 14, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Marianne Sarah Koenig, MDNPI 1619930559

Title

Owner

Phone

(508) 888-8430

Specialties & licenses 1

Addresses

Other identifiers 2

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/12354/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marianne Sarah Koenig, M.D.

  • Pediatric Adolescent Medicine Physician
  • Sandwich, MA
  • NPI 1619930559
  NPD (past) Authorized official

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497960215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "449 ROUTE 130",
            "city": "SANDWICH",
            "state": "MA",
            "postal_code": "025632339",
            "telephone_number": "508-888-8430",
            "fax_number": "508-888-6673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "449 ROUTE 130",
            "city": "SANDWICH",
            "state": "MA",
            "postal_code": "025632339",
            "telephone_number": "508-888-8430",
            "fax_number": "508-888-6673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SANDWICH PEDIATRICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KOENIG",
        "authorized_official_first_name": "MARIANNE",
        "authorized_official_middle_name": "SARAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-888-8430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MA",
            "license": "50001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9766006",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "SAM15113",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nazanin Jelveh Ronan, M.D.
• Catherine Roy, IBCLC
• Kathryn M Rudman, MD
• Richard Henry Sadowski, D.M.D.
• Sandwich Dental Associates L.L.C
• Sandwich Physical Therapy, Inc
• Sandwich Primary Care Associates, Inc
• Sandwich SNF Operations, LLC
• Peter Matthew Schortmann, DMD
• Myles La Verne Schultz, MD

• Pediatric Adolescent Medicine Physician in Sandwich, MA
• Providers in Sandwich, MA by specialty
• Pediatric Adolescent Medicine Physician in Massachusetts

• 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.