NPIMap

Individual provider Active NPI

Brian L Coolbaugh, M.D.

  • Diagnostic Radiology Physician
  • Brockton, MA
National Provider Identifier
1710094396
Registry record updated May 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
57375 Issued in MA
Practice address
235 N Pearl St
Brockton, MA 02301-1794
Phone
(508) 427-2665
Fax
(508) 427-2368
NPI assigned
Aug 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 57375 MA Primary

Addresses

Primary practice location

235 N Pearl St
Brockton, MA 02301-1794

Mailing address

960 Massachusetts Ave
FL 2
Boston, MA 02118-2690

Other practice location 1

736 Cambridge St
Brighton, MA 02135-2907
Phone (617) 789-2762

Other practice location 2

Milford Hospital
14 Prospect Street, Radiology
Milford, MA 01757
Phone (508) 422-2922

Other identifiers 2

IdentifierTypeStateIssuer
110046266AMedicaidMA
3134990MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, CT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20040406001471 MA Practitioner - Diagnostic Radiology 9133112048 Reassigns benefits to 3 organizations
I20260617002780 CT Practitioner - Diagnostic Radiology 9133112048

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Massachusetts Medical School, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

114 Woodland St
C/O Mailstop 41303 4TH Floor
Hartford, CT 06105-1299

Hospital & facility affiliations

  • Good Samaritan Medical Center Hospital, Brockton, MA, CCN 220111
  • Boston Medical Center-Brighton Hospital, Brighton, MA, CCN 220036
  • Brown University Health Morton Hospital Hospital, Taunton, MA, CCN 220073
  • Boston Medical Center Hospital, Boston, MA, CCN 220031
  • Signature Healthcare Brockton Hospital Hospital, Brockton, MA, CCN 220052

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. 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

State licenses

LicenseStateTypeSpecialty
57375MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
BMC Affiliated Physicians, Inc. Diagnostic Radiology CurrentSince Apr 1, 2025 Accepting new patients
Steward Medical Group, Inc CurrentSince May 1, 2018 Accepting new patients
Steward Medical Group, Inc CurrentSince Mar 25, 2022 Accepting new patients

Locations

960 Massachusetts Ave
Ste 2
Boston, MA 02118

736 Cambridge St
Brighton, MA 02135
Phone (617) 789-2762

235 N Pearl St
Brockton, MA 02301
Phone (508) 427-2525

851 Middle St
Ste 2100
Fall River, MA 02721
Phone (508) 235-5445

Interoperability endpoints

  • Direct secure messaging: bcoolbaugh252233@direct.bmc.masshiway.net

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 12

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779062400000",
    "number": "1710094396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVE",
            "address_2": "FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 N PEARL ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023011794",
            "telephone_number": "508-427-2665",
            "fax_number": "508-427-2368"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "736 Cambridge St",
            "address_purpose": "LOCATION",
            "city": "Brighton",
            "state": "MA",
            "postal_code": "021352907",
            "country_code": "US",
            "telephone_number": "617-789-2762",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "Milford Hospital",
            "address_2": "14 Prospect Street, Radiology",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "MA",
            "postal_code": "01757",
            "country_code": "US",
            "telephone_number": "508-422-2922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COOLBAUGH",
        "first_name": "BRIAN",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2026-05-18",
        "certification_date": "2026-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "57375",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110046266A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3134990",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.