NPIMap

Organization Active NPI

Boston Senior Medicine

  • Clinic/Center
  • Canton, MA
National Provider Identifier
1740839208
Registry record updated Nov 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
BOSTON SENIOR MEDICINE
Doing business as
Boston Senior Medicine
Practice address
345 Neponset St
Canton, MA 02021-1940
Phone
(508) 232-6963
Fax
(508) 297-8258
NPI assigned
Sep 8, 2019
Last updated
Nov 20, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2019

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

Authorized official

Name
India Michel, NPNPI 1760720213
Title
Provider
Phone
(508) 232-6963

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193200000X MULTI-SPECIALTY GROUP 183500000X
Clinic/Center 261Q00000X Primary
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

345 Neponset St
Canton, MA 02021-1940

Mailing address

345 Neponset St Ste 3
Canton, MA 02021-1988
Phone (508) 232-6963

Other names 1

  • Boston Senior Medicine Doing business as

National Provider Directory

National Provider Directory

Locations

345 Neponset St
Ste 3
Canton, MA 02021
Phone (508) 232-6963

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1567900800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574208000000",
    "number": "1740839208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 NEPONSET ST STE 3",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020211988",
            "telephone_number": "508-232-6963",
            "fax_number": "508-297-8258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 NEPONSET ST",
            "city": "CANTON",
            "state": "MA",
            "postal_code": "020211940",
            "telephone_number": "508-232-6963",
            "fax_number": "508-297-8258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSTON SENIOR MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-08",
        "last_updated": "2019-11-20",
        "status": "A",
        "authorized_official_last_name": "MICHEL",
        "authorized_official_first_name": "INDIA",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "508-232-6963",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pharmacist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boston Senior Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Boston Senior Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2019; 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.