NPIMap

Organization Active NPI

Trustees of Tufts College

  • Clinical Medical Laboratory
  • Boston, MA
National Provider Identifier
1801938014
Registry record updated Jul 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
TRUSTEES OF TUFTS COLLEGE
Practice address
1 Kneeland St
DHS-646
Boston, MA 02111-1527
Phone
(617) 636-6510
Fax
(617) 636-6780
NPI assigned
Feb 13, 2007
Organization subpart
Yes
Parent organization
TRUSTEES OF TUFTS COLLEGEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 12, 2023

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

Authorized official

Name
Lisa Gately
Title
Credentialing
Phone
(617) 636-6505

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Primary

Addresses

Primary practice location

1 Kneeland St
DHS-646
Boston, MA 02111-1527

Mailing address

1 Kneeland St
DHS-646
Boston, MA 02111-1527
Phone (617) 636-6510

Other identifiers 2

IdentifierTypeStateIssuer
228200OtherBLUE CROSS BLUE SHIELD
110000011OMedicaidMA

Other names 1

  • Tufts Oral Pathology Services Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050429000168 MA Part B Supplier - Independent Clinical Laboratory 3779522628 Practice locations: Boston, MA

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
Part of
Tufts University Lab

Locations

1 Kneeland St
#646
Boston, MA 02111
Phone (617) 636-6510

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1171324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689120000000",
    "number": "1801938014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KNEELAND ST",
            "address_2": "DHS-646",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111527",
            "telephone_number": "617-636-6510",
            "fax_number": "617-636-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 KNEELAND ST",
            "address_2": "DHS-646",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111527",
            "telephone_number": "617-636-6510",
            "fax_number": "617-636-6780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUSTEES OF TUFTS COLLEGE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "TRUSTEES OF TUFTS COLLEGE",
        "enumeration_date": "2007-02-13",
        "last_updated": "2023-07-12",
        "certification_date": "2023-07-12",
        "status": "A",
        "authorized_official_last_name": "GATELY",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "617-636-6505"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "228200",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110000011O",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tufts Oral Pathology Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 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.