Fred J Thaler, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

58249 Issued in MA

Practice address

1 Pearl St
Suite 1400
Brockton, MA 02301-2864

Phone

(508) 897-6200

Fax

(508) 897-6225

NPI assigned

Oct 17, 2005

Last updated

Jan 20, 2011By 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

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.

• Bridgewater Pediatrics LLC

  • Pediatrics Physician
  • Bridgewater, MA
  • NPI 1255579975
  NPD (past)
• Caritas Medical Group, Inc.

  • Specialist
  • Brighton, MA
  • NPI 1174513204
  NPD (past)

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295481600000",
    "number": "1629067301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PEARL ST",
            "address_2": "SUITE 1400",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023012864",
            "telephone_number": "508-897-6200",
            "fax_number": "508-897-6225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PEARL ST",
            "address_2": "SUITE 1400",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023012864",
            "telephone_number": "508-897-6200",
            "fax_number": "508-897-6225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THALER",
        "first_name": "FRED",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2011-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "58249",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3022226",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amanda Frances Tesauro
• Simret B Tesfe, MD
• Adeline Tchuenkam Teukam, LPN
• Vikas Tewari, M.D.
• Sejal Thakor, MD
• Remya Tharackal-Ravindran, M.D.
• Heather Tharpe-Bush
• The Bridge to Life Resources Inc
• The Commonwealth of Massachusetts (Brockton Multi Service center)
• The Lactation Network, LLC

• 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 Jan 20, 2011; 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.