NPIMap

Organization Active NPI

Pediatric Associates of Wellesley

  • Pediatrics Physician
  • Weston, MA
National Provider Identifier
1710028188
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC ASSOCIATES OF WELLESLEY
Practice address
134 South Ave
Weston, MA 02493-1923
Phone
(781) 736-0040
Fax
(781) 736-7929
NPI assigned
Feb 9, 2007
Last updated
Aug 22, 2020By the provider in NPPES
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
Ms. Dale E Barry
Title
Executive Director
Phone
(781) 736-0040

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

134 South Ave
Weston, MA 02493-1923

Mailing address

134 South Ave
Weston, MA 02493-1923
Phone (781) 736-0040

Other identifiers 3

IdentifierTypeStateIssuer
M15807OtherMABLUE CROSS OF MASS
713364OtherMATUFTS HEALTH PLAN
9759204MedicaidMA

National Provider Directory

National Provider Directory

Locations

266 Main St
Ste 18
Medfield, MA 02052

Interoperability endpoints

  • Direct secure messaging: zackin.michael.paofw@direct.partners.masshiway.net
  • Direct secure messaging: raftery.john.paofw@direct.partners.masshiway.net
  • Direct secure messaging: landis.david.paofw@direct.partners.masshiway.net
  • Direct secure messaging: filippine.maureen.paofw@direct.partners.masshiway.net
  • Direct secure messaging: curran.paula.paofw@direct.partners.masshiway.net
  • Direct secure messaging: yankelev.haya.paofw@direct.partners.masshiway.net
  • Direct secure messaging: blumenthal.mark.paofw@direct.partners.masshiway.net
  • Direct secure messaging: melkonian.vana.paofw@direct.partners.masshiway.net

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1710028188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 SOUTH AVE",
            "city": "WESTON",
            "state": "MA",
            "postal_code": "024931923",
            "telephone_number": "781-736-0040",
            "fax_number": "781-736-7929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 SOUTH AVE",
            "city": "WESTON",
            "state": "MA",
            "postal_code": "024931923",
            "telephone_number": "781-736-0040",
            "fax_number": "781-736-7929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOCIATES OF WELLESLEY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BARRY",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "781-736-0040",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF MASS",
            "identifier": "M15807",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "713364",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9759204",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Weston, 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.