NPIMap

Organization Active NPI

Medical Associates of Saugus PC

  • Gastroenterology Physician
  • Peabody, MA
National Provider Identifier
1568549772
Registry record updated May 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
MEDICAL ASSOCIATES OF SAUGUS PC
Practice address
One Roosevelt Avenue Suite 204
Medical Associates of Saugus
Peabody, MA 01960
Phone
(978) 536-7778
Fax
(978) 536-2998
NPI assigned
Nov 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2011

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

Authorized official

Name
John V Gandolfo, MDNPI 1548332992
Title
President
Phone
(978) 536-7778

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RG0100X Primary

Addresses

Primary practice location

One Roosevelt Avenue Suite 204
Medical Associates of Saugus
Peabody, MA 01960

Mailing address

One Roosevelt Avenue Suite 204
Medical Associates of Saugus
Peabody, MA 01960
Phone (978) 536-7778

Other identifiers 3

IdentifierTypeStateIssuer
9701133MedicaidMA
685660OtherTOFTS HEALTH PLANS MA
M17573OtherBLUE SHIELD OF MA

National Provider Directory

National Provider Directory

Locations

1 Roosevelt Ave
Ste 204
Peabody, MA 01960
Phone (978) 536-7778

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305763200000",
    "number": "1568549772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE ROOSEVELT AVENUE SUITE 204",
            "address_2": "MEDICAL ASSOCIATES OF SAUGUS",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "01960",
            "telephone_number": "978-536-7778",
            "fax_number": "978-536-2998"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE ROOSEVELT AVENUE SUITE 204",
            "address_2": "MEDICAL ASSOCIATES OF SAUGUS",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "01960",
            "telephone_number": "978-536-7778",
            "fax_number": "978-536-2998"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ASSOCIATES OF SAUGUS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2011-05-19",
        "status": "A",
        "authorized_official_last_name": "GANDOLFO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "V",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-536-7778",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Gastroenterology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9701133",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TOFTS HEALTH PLANS MA",
            "identifier": "685660",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF MA",
            "identifier": "M17573",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2011; 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.