Organization Active NPI

Salisbury Plastic Surgery PC

  • Specialist
  • Worcester, MA
National Provider Identifier
1730127523
Registry record updated Sep 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
SALISBURY PLASTIC SURGERY PC
Practice address
39 Salisbury St
Worcester, MA 01609-3160
Phone
(508) 755-4825
Fax
(508) 797-0167
NPI assigned
Jun 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2008

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

Authorized official

Name
Ms. Deborah Ekstrom, MDNPI 1518916188
Title
Owner
Phone
(508) 755-4825

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
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X Primary

Addresses

Primary practice location

39 Salisbury St
Worcester, MA 01609-3160

Mailing address

39 Salisbury St
Worcester, MA 01609-3160
Phone (508) 755-4825

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050620000287 MA Part B Supplier - Clinic/Group Practice 9032153176 Receives reassigned benefits from 1 practitioner
Practice locations: Worcester, MA

National Provider Directory

National Provider Directory

Locations

39 Salisbury St
Ste 1
Worcester, MA 01609

39 Salisbury St
Worcester, MA 01609
Phone (508) 755-1133

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": "1149292800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222214400000",
    "number": "1730127523",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39 SALISBURY ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016093160",
            "telephone_number": "508-755-4825",
            "fax_number": "508-797-0167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39 SALISBURY ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016093160",
            "telephone_number": "508-755-4825",
            "fax_number": "508-797-0167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SALISBURY PLASTIC SURGERY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-03",
        "last_updated": "2008-09-24",
        "status": "A",
        "authorized_official_last_name": "EKSTROM",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-755-4825",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Sep 24, 2008; 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.