Organization Active NPI

Child Heart Associates, LLC

  • Pediatric Cardiology Physician
  • Worcester, MA
National Provider Identifier
1700876380
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Cardiology PhysicianTaxonomy code 2080P0202X
Legal business name
CHILD HEART ASSOCIATES, LLC
Practice address
33 Oak Ave
Worcester, MA 01605-2752
Phone
(508) 757-7300
Fax
(800) 757-0803
NPI assigned
Oct 25, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Lars Erickson III, MD
Title
Managing Member
Phone
(508) 757-7300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Cardiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080P0202X MA Primary

Addresses

Primary practice location

33 Oak Ave
Worcester, MA 01605-2752

Mailing address

33 Oak Ave
Worcester, MA 01605-2752
Phone (508) 757-7300

Other identifiers 1

IdentifierTypeStateIssuer
9748661MedicaidMA

National Provider Directory

National Provider Directory

Locations

235 Plain St
Ste 301
Providence, RI 02905
Phone (401) 421-4186

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/13760/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 4

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": "1130198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1700876380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 OAK AVE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052752",
            "telephone_number": "508-757-7300",
            "fax_number": "800-757-0803"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 OAK AVE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052752",
            "telephone_number": "508-757-7300",
            "fax_number": "800-757-0803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHILD HEART ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-25",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "ERICKSON",
        "authorized_official_first_name": "LARS",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "508-757-7300",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2080P0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Pediatric Cardiology",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9748661",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.