NPIMap

Organization Active NPI

Pratt Medical Group, Inc

  • Sleep Medicine (Internal Medicine) Physician
  • Wellesley, MA
National Provider Identifier
1528240751
Registry record updated Jul 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Medicine (Internal Medicine) PhysicianTaxonomy code 207RS0012X
Legal business name
PRATT MEDICAL GROUP, INC
Practice address
873 Worcester St
Wellesley, MA 02482-3714
Phone
(617) 636-5000
NPI assigned
Nov 29, 2007
Organization subpart
Yes
Parent organization
PRATT MEDICAL GROUP, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 17, 2009

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

Authorized official

Name
Theodore Bukowski
Title
Cfo
Phone
(617) 636-5410

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Medicine (Internal Medicine) PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RS0012X Primary

Addresses

Primary practice location

873 Worcester St
Wellesley, MA 02482-3714

Mailing address

PO Box 11218
Boston, MA 02211-1218
Phone (617) 636-2546

Other identifiers 1

IdentifierTypeStateIssuer
SF063069OtherMABCBS MA

Other names 1

  • Wellesley Center for Sleep Medicine, Tufts Medical Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Pratt Medical Gorup11 organizations share this tax ID, including this one
Part of
Pratt Medical Gorup

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1196294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247788800000",
    "number": "1528240751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 11218",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022111218",
            "telephone_number": "617-636-2546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "873 WORCESTER ST",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024823714",
            "telephone_number": "617-636-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRATT MEDICAL GROUP, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PRATT MEDICAL GROUP, INC",
        "enumeration_date": "2007-11-29",
        "last_updated": "2009-07-17",
        "status": "A",
        "authorized_official_last_name": "BUKOWSKI",
        "authorized_official_first_name": "THEODORE",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "617-636-5410"
    },
    "taxonomies": [
        {
            "code": "207RS0012X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "SF063069",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Wellesley Center for Sleep Medicine, Tufts Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wellesley, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2009; 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.