NPIMap

Organization Active NPI

Northeast Allergy Asthma & Immunology, PC

  • Allergy & Immunology Physician
  • Sudbury, MA
National Provider Identifier
1861815656
Registry record updated May 4, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
Legal business name
NORTHEAST ALLERGY ASTHMA & IMMUNOLOGY, PC
Practice address
616 Boston Post Road
Sudbury, MA 01776
Phone
(978) 537-4805
Fax
(978) 261-5637
NPI assigned
Jan 29, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 4, 2015

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

Authorized official

Name
Dr. Jordan E. Scott, M.D.
Title
President/Physician
Phone
(978) 537-4805

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207K00000X Primary

Addresses

Primary practice location

616 Boston Post Road
Sudbury, MA 01776

Mailing address

79 Erdman Way
Suite 101
Leominster, MA 01453
Phone (978) 537-4805

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100416000306 MA Part B Supplier - Clinic/Group Practice 2860529203 Receives reassigned benefits from 12 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Worcester, MA; Sudbury, MA; Leominster, MA; Concord, MA; Newton, MA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Northeast Allergy Asthma and Immunology2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1390953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1430697600000",
    "number": "1861815656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 ERDMAN WAY",
            "address_2": "SUITE 101",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "01453",
            "telephone_number": "978-537-4805",
            "fax_number": "978-537-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "616 BOSTON POST ROAD",
            "city": "SUDBURY",
            "state": "MA",
            "postal_code": "01776",
            "telephone_number": "978-537-4805",
            "fax_number": "978-261-5637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST ALLERGY ASTHMA & IMMUNOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-29",
        "last_updated": "2015-05-04",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT/PHYSICIAN",
        "authorized_official_telephone_number": "978-537-4805",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sudbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.