Organization Active NPI

Romney K. Laderberg, MD, PC

  • Pulmonary Disease Physician
  • Everett, MA
National Provider Identifier
1629289681
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
73767 Issued in MA
Legal business name
ROMNEY K. LADERBERG, MD, PC
Practice address
596 Broadway
Everett, MA 02149-3743
Phone
(617) 387-5185
Fax
(617) 387-0827
NPI assigned
May 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Romney K Laderberg, MD
Title
Owner
Phone
(617) 387-5185

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RP1001X 73767 MA Primary

Addresses

Primary practice location

596 Broadway
Everett, MA 02149-3743

Mailing address

596 Broadway
Everett, MA 02149-3743
Phone (617) 387-5185

Other identifiers 3

IdentifierTypeStateIssuer
724634OtherMATUFTS
61618OtherMAHARVARD PILGRAM
3117031MedicaidMA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629289681",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "596 BROADWAY",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021493743",
            "telephone_number": "617-387-5185",
            "fax_number": "617-387-0827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "596 BROADWAY",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021493743",
            "telephone_number": "617-387-5185",
            "fax_number": "617-387-0827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROMNEY K. LADERBERG, MD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LADERBERG",
        "authorized_official_first_name": "ROMNEY",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-387-5185",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MA",
            "license": "73767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "724634",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRAM",
            "identifier": "61618",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3117031",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, 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.

Verify at the official NPI Registry.