Individual provider Active NPI

Nisha Thakrar, MD

  • Pediatrics Physician
  • South Boston, MA
National Provider Identifier
1831163443
Registry record updated Nov 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
218960 Issued in MA
Practice address
409 W Broadway
South Boston, MA 02127-2245
Phone
(617) 269-7500
Fax
(617) 464-7512
NPI assigned
Feb 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 1, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 218960 MA Primary

Addresses

Primary practice location

409 W Broadway
South Boston, MA 02127-2245

Mailing address

409 W Broadway
South Boston, MA 02127-2245
Phone (617) 269-7500

Other identifiers 6

IdentifierTypeStateIssuer
0032345OtherMANEIGHBORHOOD HEALTH PLAN
000000027659OtherMABMC HEALTHNET
325375OtherMATUFTS HEALTH PLAN
J27243OtherMABLUE CROSS
AA9809OtherMDHARVARD PILGRIM
6915000OtherMACIGNA

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
I20040527000251 MA Practitioner - Pediatric Medicine 6406837277 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Boston Community Health Center CurrentSince May 14, 2016 Accepting new patients

Locations

409 W Broadway
South Boston, MA 02127
Phone (617) 269-7500

Interoperability endpoints

  • Direct secure messaging: nthakrar161042@direct.ochin.org

Organizations & group practices 1

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": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320105600000",
    "number": "1831163443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 W BROADWAY",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021272245",
            "telephone_number": "617-269-7500",
            "fax_number": "617-464-7512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 W BROADWAY",
            "city": "SOUTH BOSTON",
            "state": "MA",
            "postal_code": "021272245",
            "telephone_number": "617-269-7500",
            "fax_number": "617-464-7512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAKRAR",
        "first_name": "NISHA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-13",
        "last_updated": "2011-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "218960",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "0032345",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BMC HEALTHNET",
            "identifier": "000000027659",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "325375",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "J27243",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "AA9809",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6915000",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Boston, MA

Sources for this page

Verify at the official NPI Registry.