NPIMap

Organization Active NPI

Mt Auburn Professional OBGYN

  • Gynecologic Oncology Physician
  • Watertown, MA
National Provider Identifier
1609291376
Registry record updated May 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecologic Oncology PhysicianTaxonomy code 207VX0201X
Legal business name
MT AUBURN PROFESSIONAL OBGYN
Practice address
One Arsenal Marketplace
Watertown, MA 02472-2861
Phone
(617) 499-5644
Fax
(617) 499-5620
NPI assigned
Mar 4, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2024

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

Authorized official

Name
Mr. Brian Smith
Title
Cfo
Phone
(405) 245-6238

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VF0040X MA
Gynecologic Oncology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VX0201X MA Primary

Addresses

Primary practice location

One Arsenal Marketplace
Watertown, MA 02472-2861

Mailing address

One Arsenal Marketplace
Watertown, MA 02472-2861
Phone (617) 499-5644

National Provider Directory

National Provider Directory
Tax ID family
Mt Auburn Prof SVCS Inc7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1393891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714867200000",
    "number": "1609291376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE ARSENAL MARKETPLACE",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024722861",
            "telephone_number": "617-499-5644",
            "fax_number": "617-499-5620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE ARSENAL MARKETPLACE",
            "city": "WATERTOWN",
            "state": "MA",
            "postal_code": "024722861",
            "telephone_number": "617-499-5644",
            "fax_number": "617-499-5620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT AUBURN PROFESSIONAL OBGYN",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-04",
        "last_updated": "2024-05-05",
        "certification_date": "2024-05-05",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "405-245-6238",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207VF0040X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Urogynecology and Reconstructive Pelvic Surgery",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "207VX0201X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watertown, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2024; 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.