Active NPI
Andrea P Tish, MD
- Pediatrics Physician
- Salem, MA
National Provider Identifier
1518077403
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 46187
- Practice address
- 57 Highland Ave
ER
Salem, MA 01970 - Phone
- (978) 354-2815
- Fax
- (978) 744-9247
- NPI assigned
- Aug 30, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 46187 | MA | Primary |
Addresses
Primary practice location
57 Highland Ave
ER
Salem, MA 01970
Mailing address
57 Highland Ave
North Shore Health Systems
Salem, MA 01970-2141
Phone (978) 354-2815
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 46187 | MA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| NSPG Billing LLC | Past | Accepting new patients |
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.
-
- Urology Physician
- Newburyport, MA
- NPI 1144981721
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187654400000",
"number": "1518077403",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "57 HIGHLAND AVE",
"address_2": "NORTH SHORE HEALTH SYSTEMS",
"city": "SALEM",
"state": "MA",
"postal_code": "019702141",
"telephone_number": "978-354-2815"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "57 HIGHLAND AVE",
"address_2": "ER",
"city": "SALEM",
"state": "MA",
"postal_code": "01970",
"telephone_number": "978-354-2815",
"fax_number": "978-744-9247"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TISH",
"first_name": "ANDREA",
"middle_name": "P",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-30",
"last_updated": "2007-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "46187",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Salem, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.