Organization Active NPI

Paul B Cotter MD PC

  • Ophthalmology Physician
  • Brockton, MA
National Provider Identifier
1891804852
Registry record updated Nov 30, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
43625 Issued in MA
Legal business name
PAUL B COTTER MD PC
Practice address
179 Quincy St
Brockton, MA 02302
Phone
(508) 586-0256
Fax
(508) 586-4544
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2011

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

Authorized official

Name
Dr. Paul Barry Cotter, MD
Title
President
Phone
(508) 586-0256

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207W00000X 43625 MA Primary

Addresses

Primary practice location

179 Quincy St
Brockton, MA 02302

Mailing address

179 Quincy St
Brockton, MA 02302
Phone (508) 586-0256

Other identifiers 3

IdentifierTypeStateIssuer
35120000OtherMDDAVIS VISION
M13897OtherMABLUE CROSS AND BLUE SHIEL
9736816MedicaidMA

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1322611200000",
    "number": "1891804852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "179 QUINCY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "02302",
            "telephone_number": "508-586-0256",
            "fax_number": "508-586-4544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 QUINCY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "02302",
            "telephone_number": "508-586-0256",
            "fax_number": "508-586-4544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL B COTTER MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2011-11-30",
        "status": "A",
        "authorized_official_last_name": "COTTER",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "BARRY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "508-586-0256",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "43625",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DAVIS VISION",
            "identifier": "35120000",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS AND BLUE SHIEL",
            "identifier": "M13897",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9736816",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2011; 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.