Individual provider Active NPI

Normand A Tanguay, MD

  • Pediatrics Physician
  • Wilmington, MA
National Provider Identifier
1568453983
Registry record updated Aug 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
151204 Issued in MA
Practice address
500 Salem St
Wilmington, MA 01887-1200
Phone
(978) 988-6209
Fax
(978) 988-6139
NPI assigned
Nov 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 151204 MA Primary

Addresses

Primary practice location

500 Salem St
Wilmington, MA 01887-1200

Mailing address

136 W Newton St
Boston, MA 02118-1203
Phone (978) 988-6209

Other practice location 1

300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-6000

Other practice location 2

41 Highland Ave
Winchester, MA 01890-1446
Phone (781) 729-9000

Other identifiers 1

IdentifierTypeStateIssuer
3189988MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230829001941 MA Practitioner - Pediatric Medicine 7315300035 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
151204MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Children'S Hospital Pediatric Associates, Inc Pediatrics CurrentSince Aug 8, 2023 Accepting new patients
Richard G. Ruben, M.D. Pediatrics Past Accepting new patients

Locations

300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956

41 Highland Ave
Winchester, MA 01890
Phone (781) 756-2000

Interoperability endpoints

  • Direct secure messaging: tanguay.normand@elincdirect.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1130976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1568453983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 W NEWTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021181203",
            "telephone_number": "978-988-6209",
            "fax_number": "978-988-6139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 SALEM ST",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "018871200",
            "telephone_number": "978-988-6209",
            "fax_number": "978-988-6139"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Longwood Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021155724",
            "country_code": "US",
            "telephone_number": "617-355-6000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "41 Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Winchester",
            "state": "MA",
            "postal_code": "018901446",
            "country_code": "US",
            "telephone_number": "781-729-9000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANGUAY",
        "first_name": "NORMAND",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-03",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "151204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3189988",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, MA

Sources for this page

Verify at the official NPI Registry.