NPIMap

Organization Active NPI

Middleboro Pediatrics, PC

  • Pediatrics Physician
  • Lakeville, MA
National Provider Identifier
1861556961
Registry record updated Oct 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
MIDDLEBORO PEDIATRICS, PC
Practice address
2 Lakeville Business Park
Lakeville, MA 02347-1236
Phone
(508) 947-0630
Fax
(508) 947-0639
NPI assigned
Dec 21, 2006
Last updated
Oct 27, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2011

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

Authorized official

Name
Dr. Neal Gerald Bornstein, M.D.
Title
President
Phone
(508) 947-0630

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X NU Primary

Addresses

Primary practice location

2 Lakeville Business Park
Lakeville, MA 02347-1236

Mailing address

2 Lakeville Business Park
Lakeville, MA 02347-1236
Phone (508) 947-0630

Other identifiers 2

IdentifierTypeStateIssuer
713191OtherMATUFTS HEALTH CARE GROUP #
9718605MedicaidMA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D0079985Middleboro Pediatrics PC2 Lakeville Business Park, Lakeville, MA 02347AccreditationDec 22, 2027

National Provider Directory

National Provider Directory

Locations

2 Lakeville Business Park
Lakeville, MA 02347
Phone (508) 947-0630

Interoperability endpoints

  • Direct secure messaging: garniene.ramune.mp@direct.partners.masshiway.net

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319673600000",
    "number": "1861556961",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 LAKEVILLE BUSINESS PARK",
            "city": "LAKEVILLE",
            "state": "MA",
            "postal_code": "023471236",
            "telephone_number": "508-947-0630",
            "fax_number": "508-947-0639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 LAKEVILLE BUSINESS PARK",
            "city": "LAKEVILLE",
            "state": "MA",
            "postal_code": "023471236",
            "telephone_number": "508-947-0630",
            "fax_number": "508-947-0639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLEBORO PEDIATRICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-21",
        "last_updated": "2011-10-27",
        "status": "A",
        "authorized_official_last_name": "BORNSTEIN",
        "authorized_official_first_name": "NEAL",
        "authorized_official_middle_name": "GERALD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-947-0630",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH CARE GROUP #",
            "identifier": "713191",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9718605",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeville, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.