NPIMap

Organization Active NPI

Personalmds, LLC

  • Internal Medicine Physician
  • Brookline, MA
National Provider Identifier
1710179197
Registry record updated Aug 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
58140 Issued in MA
Legal business name
PERSONALMDS, LLC
Practice address
33 Pond Ave
Suite B109
Brookline, MA 02445-7163
Phone
(781) 454-6187
NPI assigned
Aug 9, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 9, 2007

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

Authorized official

Name
Dr. Ronald M Katz, M.D.NPI 1508834011
Title
Physician
Phone
(781) 454-6187

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X 58140 MA Primary

Addresses

Primary practice location

33 Pond Ave
Suite B109
Brookline, MA 02445-7163

Mailing address

33 Pond Ave
Suite B109
Brookline, MA 02445-7163
Phone (781) 454-6187

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071203000179 MA Part B Supplier - Clinic/Group Practice 9234228073 Receives reassigned benefits from 12 practitioners
Practice locations: Chestnut Hill, MA

National Provider Directory

National Provider Directory

Locations

25 Boylston St
Ste 312
Chestnut Hill, MA 02467
Phone (617) 307-3200

Practitioners & affiliated clinicians

Practitioners 12

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": "1186617600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186617600000",
    "number": "1710179197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 POND AVE",
            "address_2": "SUITE B109",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024457163",
            "telephone_number": "781-454-6187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 POND AVE",
            "address_2": "SUITE B109",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024457163",
            "telephone_number": "781-454-6187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONALMDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-09",
        "last_updated": "2007-08-09",
        "status": "A",
        "authorized_official_last_name": "KATZ",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "781-454-6187",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "58140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookline, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.