NPIMap

Organization Active NPI

Methuen Podiatry Associates, LLC

  • Podiatrist
  • Methuen, MA
National Provider Identifier
1508155797
Registry record updated Mar 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
1567 Issued in MA
Legal business name
METHUEN PODIATRY ASSOCIATES, LLC
Practice address
191 Broadway
Methuen, MA 01844-3837
Phone
(978) 682-0382
Fax
(978) 975-3585
NPI assigned
Mar 29, 2011
Organization subpart
Yes
Parent organization
METHUEN PODIATRY ASSOCIATES, LLPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 29, 2011

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

Authorized official

Name
Dr. Marc David Klein, D.P.M.NPI 1376529222
Title
Partner
Phone
(978) 682-0382

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 1567 MA Primary

Addresses

Primary practice location

191 Broadway
Methuen, MA 01844-3837

Mailing address

191 Broadway
Methuen, MA 01844-3837
Phone (978) 682-0382

Other identifiers 1

IdentifierTypeStateIssuer
9756680MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160105000062 MA Part B Supplier - Clinic/Group Practice 4284936527 Receives reassigned benefits from 5 practitioners
Practice locations: Methuen, MA

National Provider Directory

National Provider Directory
Part of
Methuen Podiatry Associates

Locations

386 Merrimack St
Ste 1B
Methuen, MA 01844
Phone (978) 682-0382

Practitioners & affiliated clinicians

Practitioners 5

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": "1301356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301356800000",
    "number": "1508155797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 BROADWAY",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018443837",
            "telephone_number": "978-682-0382",
            "fax_number": "978-975-3585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 BROADWAY",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018443837",
            "telephone_number": "978-682-0382",
            "fax_number": "978-975-3585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METHUEN PODIATRY ASSOCIATES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "METHUEN PODIATRY ASSOCIATES, LLP",
        "enumeration_date": "2011-03-29",
        "last_updated": "2011-03-29",
        "status": "A",
        "authorized_official_last_name": "KLEIN",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "978-682-0382",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "MA",
            "license": "1567",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9756680",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Methuen, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.