NPIMap

Organization Active NPI

Central Square Medical Center Inc

  • Clinic/Center
  • East Boston, MA
National Provider Identifier
1750528352
Registry record updated Jan 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
261Q00000X Issued in MA
Legal business name
CENTRAL SQUARE MEDICAL CENTER INC
Practice address
40 Central SQ
East Boston, MA 02128-1911
Phone
(617) 202-9036
NPI assigned
Jan 19, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2009

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

Authorized official

Name
Leonid Gorbatov
Title
Administrator /Officer
Phone
(301) 366-3844

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 261Q00000X MA Primary

Addresses

Primary practice location

40 Central SQ
East Boston, MA 02128-1911

Mailing address

40 Central SQ
East Boston, MA 02128-1911
Phone (617) 202-9036

National Provider Directory

National Provider Directory

Locations

40 William Kelly Sq
East Boston, MA 02128
Phone (617) 202-9036

NPI Registry JSON

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

{
    "created_epoch": "1232323200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232323200000",
    "number": "1750528352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 CENTRAL SQ",
            "city": "EAST BOSTON",
            "state": "MA",
            "postal_code": "021281911",
            "telephone_number": "617-202-9036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 CENTRAL SQ",
            "city": "EAST BOSTON",
            "state": "MA",
            "postal_code": "021281911",
            "telephone_number": "617-202-9036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL SQUARE MEDICAL CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-19",
        "last_updated": "2009-01-19",
        "status": "A",
        "authorized_official_last_name": "GORBATOV",
        "authorized_official_first_name": "LEONID",
        "authorized_official_title_or_position": "ADMINISTRATOR /OFFICER",
        "authorized_official_telephone_number": "301-366-3844"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MA",
            "license": "261Q00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2009; 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.