NPIMap

Organization Active NPI

Garden City Pediatric Assoc, LLC

  • Pediatrics Physician
  • Beverly, MA
National Provider Identifier
1598868564
Registry record updated Oct 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
GARDEN CITY PEDIATRIC ASSOC, LLC
Practice address
83 Herrick St
Ste 1003
Beverly, MA 01915
Phone
(978) 927-4980
NPI assigned
Sep 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2007

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

Authorized official

Name
Dr. Jacob D Kriteman, MD
Title
Physician
Phone
(978) 527-4980

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

83 Herrick St
Ste 1003
Beverly, MA 01915

Mailing address

83 Herrick St
Ste 1003
Beverly, MA 01915
Phone (978) 927-4980

Other identifiers 2

IdentifierTypeStateIssuer
9707433MedicaidMA
M12092OtherBCBS

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D0072854Garden City Pediatric Associates83 Herrick St, Ste 1003, Beverly, MA 01915Certificate of waiverNov 8, 2026

National Provider Directory

National Provider Directory

Locations

83 Herrick St
Ste 1003
Beverly, MA 01915
Phone (978) 927-4980

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/16569/brand/2/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 11

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": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191974400000",
    "number": "1598868564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 HERRICK ST",
            "address_2": "STE 1003",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "01915",
            "telephone_number": "978-927-4980"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 HERRICK ST",
            "address_2": "STE 1003",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "01915",
            "telephone_number": "978-927-4980"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GARDEN CITY PEDIATRIC ASSOC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2007-10-10",
        "status": "A",
        "authorized_official_last_name": "KRITEMAN",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "978-527-4980",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9707433",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "M12092",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.