Active NPI
Foundation Medicine, Inc.
- Clinical Medical Laboratory
- Morrisville, NC
National Provider Identifier
1508215922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Medical Laboratory
- Legal business name
- FOUNDATION MEDICINE, INC.
- Practice address
- 7010 Kit Creek Rd
Morrisville, NC 27560-9761 - Phone
- (617) 418-2200
- NPI assigned
- Jun 7, 2016
- Organization subpart
- Yes
- Parent organization
- FOUNDATION MEDICINE, INC.
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Bahareh Jafari
- Title
- Senior Manager, Revenue
- Phone
- (781) 707-6322
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Medical Laboratory | 291U00000X | Primary |
Addresses
Primary practice location
7010 Kit Creek Rd
Morrisville, NC 27560-9761
Mailing address
150 2ND St
Cambridge, MA 02141-2115
Phone (617) 418-2200
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34D2044309 | Other | NC | CLIA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160809003228 | NC | Part B Supplier - Independent Clinical Laboratory | 6800054693 |
1 other NPI on this enrollment Practice locations: Morrisville, NC |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
Other NPIs on the same Medicare enrollment 1
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Tax ID family
- Foundation Medicine Inc
- Part of
- Foundation Medicine Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Clinical Medical Laboratory
- Boston, MA
- NPI 1720688054
Locations
150 2nd St
Cambridge, MA 02141
Phone (617) 418-2200
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1465257600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1604966400000",
"number": "1508215922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 2ND ST",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021412115",
"telephone_number": "617-418-2200",
"fax_number": "617-418-2290"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7010 KIT CREEK RD",
"city": "MORRISVILLE",
"state": "NC",
"postal_code": "275609761",
"telephone_number": "617-418-2200"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FOUNDATION MEDICINE, INC.",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "FOUNDATION MEDICINE, INC.",
"enumeration_date": "2016-06-07",
"last_updated": "2020-11-10",
"certification_date": "2020-11-10",
"status": "A",
"authorized_official_last_name": "JAFARI",
"authorized_official_first_name": "BAHAREH",
"authorized_official_title_or_position": "SENIOR MANAGER, REVENUE",
"authorized_official_telephone_number": "781-707-6322"
},
"taxonomies": [
{
"code": "291U00000X",
"taxonomy_group": "",
"desc": "Clinical Medical Laboratory",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CLIA",
"identifier": "34D2044309",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Morrisville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; 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.