Organization Active NPI

Sepulveda & Associates, PC

  • Nephrology Physician
  • Chelmsford, MA
National Provider Identifier
1891992194
Registry record updated Aug 8, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
SEPULVEDA & ASSOCIATES, PC
Practice address
9 North Rd
Suite 101
Chelmsford, MA 01824-2755
Phone
(978) 458-2005
NPI assigned
Jun 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2012

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

Authorized official

Name
Sebastian G SepulvedaNPI 1558343129
Title
Ceo
Phone
(978) 458-2005

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

9 North Rd
Suite 101
Chelmsford, MA 01824-2755

Mailing address

9 North Road
Suite 101
Chelmsford, MA 01824-2710
Phone (978) 458-2005

Other identifiers 3

IdentifierTypeStateIssuer
M21683OtherMAMEDICARE GROUP
M18978OtherMABLUE CROSS
9751581MedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050628000515 MA Part B Supplier - Clinic/Group Practice 9133164304 Receives reassigned benefits from 1 practitioner
Practice locations: Chelmsford, MA

National Provider Directory

National Provider Directory

Locations

9 North Rd
Unit 101
Chelmsford, MA 01824
Phone (978) 458-2005

33 Bartlett St
Ste 501
Lowell, MA 01852
Phone (978) 425-1496

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/3a5f2b67-21a2-4bcc-959e-bdff6da685ae/

Practitioners & affiliated clinicians

Practitioners 2

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": "1183075200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344384000000",
    "number": "1891992194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 NORTH ROAD",
            "address_2": "SUITE 101",
            "city": "CHELMSFORD",
            "state": "MA",
            "postal_code": "018242710",
            "telephone_number": "978-458-2005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 NORTH RD",
            "address_2": "SUITE 101",
            "city": "CHELMSFORD",
            "state": "MA",
            "postal_code": "018242755",
            "telephone_number": "978-458-2005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEPULVEDA & ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-29",
        "last_updated": "2012-08-08",
        "status": "A",
        "authorized_official_last_name": "SEPULVEDA",
        "authorized_official_first_name": "SEBASTIAN",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "978-458-2005"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "M21683",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "M18978",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9751581",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chelmsford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2012; 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.