Thomas J Faldetta, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

55036 Issued in MA

Practice address

291 Independence Dr
Internal Medicine
Chestnut Hill, MA 02467-3628

Phone

(617) 541-6505

Fax

(617) 541-6444

NPI assigned

Feb 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309132800000",
    "number": "1740254465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 MILK ST",
            "address_2": "PROVIDER ENROLLMENT - 9TH FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021094806",
            "telephone_number": "617-559-8374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "291 INDEPENDENCE DR",
            "address_2": "INTERNAL MEDICINE",
            "city": "CHESTNUT HILL",
            "state": "MA",
            "postal_code": "024673628",
            "telephone_number": "617-541-6505",
            "fax_number": "617-541-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALDETTA",
        "first_name": "THOMAS",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2011-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "55036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3062228",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "055036",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "J09777",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "PM443",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Epoch SLV LLL
• Ronald Brian Etskovitz, D.P.M.
• Briget Antoinette Evans, L.I.C.S.W
• Eyespot, LLC
• Joanne L. Faber, MSN, ANP-BC, JD
• Sandy J Falk, MD
• Marisa Adele Fanelli
• Laura Beth Fanning
• Rosemary Farahmand, MD
• Lori A Farnan, M.D.

• Internal Medicine Physician in Chestnut Hill, MA
• Providers in Chestnut Hill, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2011; 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.