Organization Active NPI

Westborough Podiatry PLLC

  • Podiatrist
  • Westborough, MA
National Provider Identifier
1720370661
Registry record updated May 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
1359 Issued in MA
Legal business name
WESTBOROUGH PODIATRY PLLC
Practice address
45 Lyman St
Suite 10
Westborough, MA 01581-2628
Phone
(508) 836-0200
Fax
(508) 836-0282
NPI assigned
May 11, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 11, 2011

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

Authorized official

Name
James D Karadimos, DPMNPI 1134200801
Title
President
Phone
(508) 836-0200

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
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X 1359 MA Primary

Addresses

Primary practice location

45 Lyman St
Suite 10
Westborough, MA 01581-2628

Mailing address

45 Lyman St
Suite 10
Westborough, MA 01581-2628
Phone (508) 836-0200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20120131000221 MA Part B Supplier - Clinic/Group Practice 6103083324 Receives reassigned benefits from 1 practitioner
Practice locations: Westboro, MA
O20121226000214 MA DME Supplier - Physician - General Practice 6103083324 Practice locations: Westborough, MA

National Provider Directory

National Provider Directory

Locations

45 Lyman St
Ste 10
Westborough, MA 01581
Phone (508) 836-0200

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EFGDBD

Practitioners & affiliated clinicians

Practitioners 1

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": "1305072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305072000000",
    "number": "1720370661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 LYMAN ST",
            "address_2": "SUITE 10",
            "city": "WESTBOROUGH",
            "state": "MA",
            "postal_code": "015812628",
            "telephone_number": "508-836-0200",
            "fax_number": "508-836-0282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 LYMAN ST",
            "address_2": "SUITE 10",
            "city": "WESTBOROUGH",
            "state": "MA",
            "postal_code": "015812628",
            "telephone_number": "508-836-0200",
            "fax_number": "508-836-0282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTBOROUGH PODIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-11",
        "last_updated": "2011-05-11",
        "status": "A",
        "authorized_official_last_name": "KARADIMOS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-836-0200",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": "MA",
            "license": "1359",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westborough, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2011; 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.