Individual provider Active NPI

Ruth Prophete, MD

  • Pediatrics Physician
  • New Bedford, MA
National Provider Identifier
1841274081
Registry record updated Jan 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
206719 Issued in MA
Practice address
81 Hawthorn St # R
New Bedford, MA 02740-3429
Phone
(508) 961-2403
Fax
(508) 961-2406
NPI assigned
Dec 1, 2005
Last updated
Jan 6, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2012

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 206719 MA Primary

Addresses

Primary practice location

81 Hawthorn St # R
New Bedford, MA 02740-3429

Mailing address

81 Hawthorn St # R
New Bedford, MA 02740-3429
Phone (508) 961-2403

Other identifiers 1

IdentifierTypeStateIssuer
0122416MedicaidMA

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
I20070319000057 MA Practitioner - Pediatric Medicine 0749383412 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Children's Hospital Pediatric Associates, Inc Pediatrics CurrentSince Aug 20, 2013 Accepting new patients
Brockton Hospital, Inc. Past Accepting new patients
Southcoast Hospitals Group, Inc Past Accepting new patients
Horizon Pediatrics Inc. Past Accepting new patients
Southcoast Primary Care Inc Pediatrics Past Accepting new patients

Locations

300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956

81 Hawthorn St
#R
New Bedford, MA 02740
Phone (508) 961-2403

Interoperability endpoints

  • Direct secure messaging: rprophet6232@direct.southcoast.org
  • Direct secure messaging: rprophete7363@direct.chppoc.masshiway.net

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1133395200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325808000000",
    "number": "1841274081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "81 HAWTHORN ST # R",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "027403429",
            "telephone_number": "508-961-2403",
            "fax_number": "508-961-2406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "81 HAWTHORN ST # R",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "027403429",
            "telephone_number": "508-961-2403",
            "fax_number": "508-961-2406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PROPHETE",
        "first_name": "RUTH",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-01",
        "last_updated": "2012-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "206719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0122416",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bedford, MA

Sources for this page

Verify at the official NPI Registry.