NPIMap

Organization Active NPI

Neurosurgery Center of Southern New England, PC

  • Neurological Surgery Physician
  • Fall River, MA
National Provider Identifier
1811304355
Registry record updated Sep 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
249870 Issued in MA
Legal business name
NEUROSURGERY CENTER OF SOUTHERN NEW ENGLAND, PC
Practice address
277 Pleasant St Ste 101
Fall River, MA 02721-3005
Phone
(508) 672-0545
Fax
(508) 672-0547
NPI assigned
Jul 16, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2023

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

Authorized official

Name
Charles Kanaly, M.D.NPI 1568637296
Title
President
Phone
(508) 207-5138

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207T00000X 249870 MA Primary

Addresses

Primary practice location

277 Pleasant St Ste 101
Fall River, MA 02721-3005

Mailing address

17 High Ridge Dr
Mattapoisett, MA 02739-1662
Phone (508) 672-0545

Other names 1

  • The Neurosurgery Center of Southern New England, PC Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150227000652 MA Part B Supplier - Clinic/Group Practice 1254657752 Receives reassigned benefits from 12 practitioners
Practice locations: Dartmouth, MA; Fall River, MA

National Provider Directory

National Provider Directory

Locations

277 Pleasant St
#101
Fall River, MA 02721
Phone (508) 672-0545

Practitioners & affiliated clinicians

Practitioners 12

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

NPI Registry JSON

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

{
    "created_epoch": "1405468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693872000000",
    "number": "1811304355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 HIGH RIDGE DR",
            "city": "MATTAPOISETT",
            "state": "MA",
            "postal_code": "027391662",
            "telephone_number": "508-672-0545",
            "fax_number": "508-672-0547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 PLEASANT ST STE 101",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027213005",
            "telephone_number": "508-672-0545",
            "fax_number": "508-672-0547"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROSURGERY CENTER OF SOUTHERN NEW ENGLAND, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-16",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A",
        "authorized_official_last_name": "KANALY",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-207-5138",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": "MA",
            "license": "249870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Neurosurgery Center of Southern New England, PC",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "The Neurosurgery Center of Southern New England, PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Fall River, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 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.