Individual provider Active NPI

Edward A Chibaro, M.D.

  • Urology Physician
  • Derry, NH
National Provider Identifier
1861451239
Registry record updated Mar 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
NH6724 Issued in NH
Practice address
44 Birch St
Derry, NH 03038-2752
Phone
(603) 434-6380
Fax
(603) 434-3626
NPI assigned
Mar 22, 2006
Last updated
Mar 4, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X NH6724 NH Primary

Addresses

Primary practice location

44 Birch St
Derry, NH 03038-2752

Mailing address

44 Birch St
Derry, NH 03038-2752
Phone (603) 434-6380

Other identifiers 9

IdentifierTypeStateIssuer
4146695OtherNHMVP HEALTHCARE
0104597Y0NH02OtherNHANTHEM BCBS
93989OtherNHAETNA
NH0991OtherMABLUE CROSS BLUE SHIELD
81340991MedicaidNH
B85951OtherNHHARVARD PILGRIM
006724OtherNHTUFTS HEALTH PLAN
1904021OtherNHUNITED HEALTHCARE
5150OtherNHHEALTHSOURCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
NH6724NHMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Urological Surgery P.a. Urology CurrentSince Jan 1, 1985 Accepting new patients
Merrimack Valley Sonographic Services,Inc. PastSince Nov 1, 1998 Accepting new patients

Locations

44 Birch St
Ste 303
Derry, NH 03038
Phone (603) 421-2098

168 Kinsley St
Ste 20
Nashua, NH 03060
Phone (603) 880-3541

Organizations & group practices 2

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": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393891200000",
    "number": "1861451239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 BIRCH ST",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030382752",
            "telephone_number": "603-434-6380",
            "fax_number": "603-434-3626"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 BIRCH ST",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "030382752",
            "telephone_number": "603-434-6380",
            "fax_number": "603-434-3626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIBARO",
        "first_name": "EDWARD",
        "middle_name": "A",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2014-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NH",
            "license": "NH6724",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP HEALTHCARE",
            "identifier": "4146695",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "0104597Y0NH02",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "93989",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "NH0991",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "81340991",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "B85951",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "006724",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1904021",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHSOURCE",
            "identifier": "5150",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Derry, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2014; 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.