NPIMap

Organization Active NPI

Caritas Good Samaritan Medical Center-Diagnostic Facility

  • General Acute Care Hospital
  • Brockton, MA
National Provider Identifier
1811084643
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
CARITAS GOOD SAMARITAN MEDICAL CENTER-DIAGNOSTIC FACILITY
Practice address
1 Pearl St
Brockton, MA 02301-2864
Phone
(508) 427-3668
NPI assigned
Oct 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Paul Burns
Title
Executive Director
Phone
(508) 427-2217

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Primary

Addresses

Primary practice location

1 Pearl St
Brockton, MA 02301-2864

Mailing address

77 Warren Street
Provider Enrollment Dept
Brighton, MA 02135
Phone (617) 562-5482

Other identifiers 1

IdentifierTypeStateIssuer
1210009MedicaidMA

National Provider Directory

National Provider Directory
Tax ID family
Caritas Good Samaritan Medical Center-Cardiac Fitness7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1811084643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 WARREN STREET",
            "address_2": "PROVIDER ENROLLMENT DEPT",
            "city": "BRIGHTON",
            "state": "MA",
            "postal_code": "02135",
            "telephone_number": "617-562-5482",
            "fax_number": "617-562-5359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PEARL ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023012864",
            "telephone_number": "508-427-3668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARITAS GOOD SAMARITAN MEDICAL CENTER-DIAGNOSTIC FACILITY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BURNS",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "508-427-2217"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1210009",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.