NPIMap

Organization Active NPI

Preventive Medicine Associates

Doing business as Boston Family Practice

  • Addiction Medicine (Family Medicine) Physician
  • Boston, MA
National Provider Identifier
1871759498
Registry record updated Aug 3, 2008
On this page

OIG exclusion record

The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:

  • Section 1128a(1) exclusion effective Sep 20, 2015.

Matched on NPI only. Confirm current status with the OIG exclusions search before relying on it.

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X
Legal business name
PREVENTIVE MEDICINE ASSOCIATES
Doing business as
Boston Family Practice
Practice address
59 Temple PL
Suite 664
Boston, MA 02111-1307
Phone
(617) 542-7860
NPI assigned
Aug 3, 2008
Organization subpart
Yes
Parent organization
PREVENTIVE MEDICINE ASSOCIATESAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 3, 2008

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

Authorized official

Name
Ms. Mary J Delong, MM, RHIA
Title
Credentialing Manager
Phone
(413) 222-7711

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0401X Primary

Addresses

Primary practice location

59 Temple PL
Suite 664
Boston, MA 02111-1307

Mailing address

59 Temple PL
Suite 664
Boston, MA 02111-1307
Phone (617) 542-7860

Other names 1

  • Boston Family Practice Doing business as

Medicare participation

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

National Provider Directory

National Provider Directory
Tax ID family
Springfield International Health Center29 organizations share this tax ID, including this one
Part of
Springfield International Health Center

Other organizations with this tax ID 28

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

View all 28

Locations

59 Temple Pl
Unit 664
Boston, MA 02111
Phone (617) 542-7860

59 Temple Pl
Ste 612
Boston, MA 02111

NPI Registry JSON

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

{
    "created_epoch": "1217721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217721600000",
    "number": "1871759498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "59 TEMPLE PL",
            "address_2": "SUITE 664",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111307",
            "telephone_number": "617-542-7860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 TEMPLE PL",
            "address_2": "SUITE 664",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111307",
            "telephone_number": "617-542-7860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREVENTIVE MEDICINE ASSOCIATES",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREVENTIVE MEDICINE ASSOCIATES",
        "enumeration_date": "2008-08-03",
        "last_updated": "2008-08-03",
        "status": "A",
        "authorized_official_last_name": "DELONG",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "413-222-7711",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MM, RHIA"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Addiction Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Boston Family Practice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.