NPIMap

Organization Active NPI

Mt Auburn Therapeutic Endoscopy

  • Gastroenterology Physician
  • Cambridge, MA
National Provider Identifier
1538232871
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
71422 Issued in MA
Legal business name
MT AUBURN THERAPEUTIC ENDOSCOPY
Practice address
300 Mount Auburn St
Ste 405
Cambridge, MA 02138-5600
Phone
(617) 661-0221
Fax
(617) 661-3862
NPI assigned
Nov 16, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Frederick W Ruymann, MDNPI 1568466316
Title
Owner
Phone
(617) 661-0221

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 71422 MA Primary

Addresses

Primary practice location

300 Mount Auburn St
Ste 405
Cambridge, MA 02138-5600

Mailing address

One Arsenal Marketplace
Watertown, MA 02472
Phone (617) 673-1851

Other identifiers 2

IdentifierTypeStateIssuer
3052788MedicaidMA
M17551OtherMABLUE CROSS GROUP

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1163635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1538232871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE ARSENAL MARKETPLACE",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "02472",
            "telephone_number": "617-673-1851",
            "fax_number": "617-499-5579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 MOUNT AUBURN ST",
            "address_2": "STE 405",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385600",
            "telephone_number": "617-661-0221",
            "fax_number": "617-661-3862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT AUBURN THERAPEUTIC ENDOSCOPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUYMANN",
        "authorized_official_first_name": "FREDERICK",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-661-0221",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MA",
            "license": "71422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3052788",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP",
            "identifier": "M17551",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • 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.