Active NPI
Longwood Orthopedic Associates, Inc.
- Orthopaedic Surgery Physician
- Chestnut Hill, MA
National Provider Identifier
1609892892
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- Legal business name
- LONGWOOD ORTHOPEDIC ASSOCIATES, INC.
- Practice address
- 830 Boylston St
Suite 106
Chestnut Hill, MA 02467-2503 - Phone
- (617) 277-1205
- Fax
- (617) 232-6528
- NPI assigned
- Jul 14, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. David A. Mattingly, M.D.
- Title
- Vice President
- Phone
- (617) 277-1205
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | Primary |
Addresses
Primary practice location
830 Boylston St
Suite 106
Chestnut Hill, MA 02467-2503
Mailing address
830 Boylston St
Suite 106
Chestnut Hill, MA 02467-2503
Phone (617) 277-1205
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9714472 | Medicaid | MA |
National Provider Directory
National Provider DirectoryLocations
123 Waterhouse Rd
Uppr Cpe
Bourne, MA 02532
Phone (617) 277-1205
830 Boylston St
Ste 106
Chestnut Hill, MA 02467
Phone (617) 277-1205
40 Allied Dr
#108
Dedham, MA 02026
Phone (617) 277-1205
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Adult Reconstructive Orthopaedic Surgery Physician
- Chestnut Hill, MA
- NPI 1962469353
-
- Orthopaedic Surgery Physician
- Chestnut Hill, MA
- NPI 1265408462
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152835200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1609892892",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "830 BOYLSTON ST",
"address_2": "SUITE 106",
"city": "CHESTNUT HILL",
"state": "MA",
"postal_code": "024672503",
"telephone_number": "617-277-1205",
"fax_number": "617-232-6528"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "830 BOYLSTON ST",
"address_2": "SUITE 106",
"city": "CHESTNUT HILL",
"state": "MA",
"postal_code": "024672503",
"telephone_number": "617-277-1205",
"fax_number": "617-232-6528"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LONGWOOD ORTHOPEDIC ASSOCIATES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2006-07-14",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "MATTINGLY",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "A.",
"authorized_official_title_or_position": "VICE PRESIDENT",
"authorized_official_telephone_number": "617-277-1205",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Orthopaedic Surgery",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9714472",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Chestnut Hill, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.