Individual provider Active NPI

Paul S Freedberg, MD

  • Urology Physician
  • Newburyport, MA
National Provider Identifier
1801825351
Registry record updated Jun 21, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
40923 Issued in MA
Practice address
1 Wallace Bashaw Way
Suite 3003
Newburyport, MA 01950-3875
Phone
(978) 997-1400
Fax
(978) 997-1401
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 40923 MA Primary

Addresses

Primary practice location

1 Wallace Bashaw Way
Suite 3003
Newburyport, MA 01950-3875

Mailing address

400 Highland Ave
Suite 6
Salem, MA 01970-7003
Phone (978) 741-4133

Other identifiers 1

IdentifierTypeStateIssuer
0114995MedicaidMA

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)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277078400000",
    "number": "1801825351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 HIGHLAND AVE",
            "address_2": "SUITE 6",
            "city": "SALEM",
            "state": "MA",
            "postal_code": "019707003",
            "telephone_number": "978-741-4133",
            "fax_number": "978-741-7742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WALLACE BASHAW WAY",
            "address_2": "SUITE 3003",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "019503875",
            "telephone_number": "978-997-1400",
            "fax_number": "978-997-1401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREEDBERG",
        "first_name": "PAUL",
        "middle_name": "S",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2010-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MA",
            "license": "40923",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0114995",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburyport, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2010; 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.