Individual provider Active NPI

Ekaterina Brodski-Quigley, M.D.

  • Family Medicine Physician
  • Waltham, MA
National Provider Identifier
1821254046
Registry record updated Aug 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
247612 Issued in MA
Practice address
1030 Main St
Waltham, MA 02451-7447
Phone
(781) 894-6900
NPI assigned
Aug 7, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 247612 MA Primary

Addresses

Primary practice location

1030 Main St
Waltham, MA 02451-7447

Mailing address

51 Wheeler Rd
Warwick, MA 01378-9345

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110901000268 MA Practitioner - Family Practice 0547430423 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Massachusetts Medical School, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Patriot Urgent Care Professionals PCGroup PAC ID 8820248784, 41 clinicians

Practice addresses (Care Compare)

16 Main St
Stoneham, MA 02180-3334
Phone (781) 279-4000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Patriot Urgent Care Professionals PC CurrentSince Nov 1, 2013 Accepting new patients
Patriot Urgent Care Professionals, PC CurrentSince Nov 1, 2013 Accepting new patients
Heywood Medical Group Inc. Family Medicine Past Accepting new patients

Locations

154 Great Rd
Bedford, MA 01730
Phone (781) 430-8161

90 Middlesex Tpke
Unit 5
Burlington, MA 01803
Phone (781) 894-6900

16 Main St
Stoneham, MA 02180
Phone (781) 279-4000

1030 Main St
Waltham, MA 02451
Phone (781) 894-6900

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1218067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407715200000",
    "number": "1821254046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "51 WHEELER RD",
            "city": "WARWICK",
            "state": "MA",
            "postal_code": "013789345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 MAIN ST",
            "city": "WALTHAM",
            "state": "MA",
            "postal_code": "024517447",
            "telephone_number": "781-894-6900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRODSKI-QUIGLEY",
        "first_name": "EKATERINA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-07",
        "last_updated": "2014-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "247612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waltham, MA

Sources for this page

Verify at the official NPI Registry.