Douglass Bibuld, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

151680 Issued in MA

Practice address

63 Main St
Brockton, MA 02301-4042

Phone

(508) 559-6699

Fax

(508) 559-5073

NPI assigned

Mar 1, 2007

Last updated

May 25, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dbibuld842156@direct.ochin.org
• FHIR API: https://epicproxy.et1290.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Brockton Neighborhood Health Center

  • Federally Qualified Health Center (FQHC)
  • Brockton, MA
  • NPI 1225085319
  Medicare reassignment NPD
• Brockton Neighborhood Health Center, Inc.

  dba BNHC Pharmacy

  • Community/Retail Pharmacy
  • Brockton, MA
  • NPI 1528704061
  NPD
• Boston University Family Medicine, Inc.

  • Family Medicine Physician
  • Boston, MA
  • NPI 1134166390
  NPD (past)
• Rehabilitation Medical Associates, P.C.

  • Internal Medicine Physician
  • Braintree, MA
  • NPI 1235183955
  NPD (past)

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464134400000",
    "number": "1568590487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014042",
            "telephone_number": "508-559-6699",
            "fax_number": "508-559-5073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014042",
            "telephone_number": "508-559-6699",
            "fax_number": "508-559-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIBULD",
        "first_name": "DOUGLASS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2016-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "151680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3158110",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James M Bevilacqua, MD
• Elizabeth A Bevis
• Beyond Independent Living LLC
• Vijaya Surekha Bhamidipati, M.D
• John Bibler III, LICSW
• Andrew John Bickford
• Engel Berto Bido Santos, MD
• Big Hearts Home Care Services
• Bill Vagenas, DMD, LLC (Vagenas Dental)
• Jennifer Jeanne Bingham-Maas, M.A.CCC-SLP

• Internal Medicine Physician in Brockton, MA
• Providers in Brockton, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.