NPIMap

Organization Active NPI

Brian D Tedesco, DPM & George a Abboud, DPM PC

  • Podiatrist
  • Nashua, NH
National Provider Identifier
1740960574
Registry record updated Sep 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
BRIAN D TEDESCO, DPM & GEORGE A ABBOUD, DPM PC
Practice address
255 Main St Unit 1
Nashua, NH 03060-2929
Phone
(603) 459-8760
Fax
(603) 459-8758
NPI assigned
Jul 18, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 21, 2023

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

Authorized official

Name
Sheila Antimone
Title
Office Manager
Phone
(781) 944-4044

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213E00000X Primary
Foot Surgery PodiatristGroup: 193200000X MULTI-SPECIALTY GROUP 213ES0131X

Addresses

Primary practice location

255 Main St Unit 1
Nashua, NH 03060-2929

Mailing address

607 North Ave
Door 17
Wakefield, MA 01880
Phone (781) 944-4044

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240411003243 NH DME Supplier - Physician - Podiatry 7517060593 Practice locations: Nashua, NH

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Brian D Tedesco DPM George5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

Locations

785 Massachusetts Ave
Arlington, MA 02476
Phone (781) 316-1522

10 Richardson Ave
Wakefield, MA 01880
Phone (781) 245-1223

Practitioners & affiliated clinicians

Practitioners 7

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": "1689638400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695254400000",
    "number": "1740960574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 NORTH AVE",
            "address_2": "DOOR 17",
            "city": "WAKEFIELD",
            "state": "MA",
            "postal_code": "01880",
            "telephone_number": "781-944-4044",
            "fax_number": "781-944-4050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 MAIN ST UNIT 1",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030602929",
            "telephone_number": "603-459-8760",
            "fax_number": "603-459-8758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIAN D TEDESCO, DPM & GEORGE A ABBOUD, DPM PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-18",
        "last_updated": "2023-09-21",
        "certification_date": "2023-09-21",
        "status": "A",
        "authorized_official_last_name": "ANTIMONE",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "781-944-4044"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "213ES0131X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Podiatrist, Foot Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashua, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2023; 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.