Active NPI
Vasiliki Vlacha, M.D.
- Pediatrics Physician
- Brockton, MA
National Provider Identifier
1568700516
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 254593
- Practice address
- 63 Main St
Brockton, MA 02301-4042 - Phone
- (508) 559-6699
- Fax
- (508) 559-5073
- NPI assigned
- Jan 26, 2013
- Last updated
- Jul 12, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | MD8275 | RI | |
| Pediatrics Physician | 208000000X | 254593 | MA | Primary |
Addresses
Primary practice location
63 Main St
Brockton, MA 02301-4042
Mailing address
63 Main St
Brockton, MA 02301-4042
Phone (781) 806-0638
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD8275 | RI | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1359158400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373587200000",
"number": "1568700516",
"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": "781-806-0638",
"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": "VLACHA",
"first_name": "VASILIKI",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-01-26",
"last_updated": "2013-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "RI",
"license": "MD8275",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "254593",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.