Individual provider Active NPI

Pavlos Papamanolis

  • Pharmacist
  • Somerville, MA
National Provider Identifier
1760355721
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH1002677 Issued in MA
Practice address
343 Broadway
Somerville, MA 02145-2407
Phone
(617) 628-1010
NPI assigned
Sep 25, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH1002677 MA Primary

Addresses

Primary practice location

343 Broadway
Somerville, MA 02145-2407

Mailing address

12 Gerrys Landing Rd
Cambridge, MA 02138-5512

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PH1002677MAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1758758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1760355721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 GERRYS LANDING RD",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 BROADWAY",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021452407",
            "telephone_number": "617-628-1010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAPAMANOLIS",
        "first_name": "PAVLOS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-09-25",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MA",
            "license": "PH1002677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2025; 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.