Access MD

Primary specialty

Exclusive Provider OrganizationTaxonomy code 302F00000X

License

56153 Issued in MA

Legal business name

ACCESS MD

Practice address

873 Worcester St
Wellesley, MA 02482-3714

Phone

(781) 416-5200

Fax

(781) 416-0956

NPI assigned

Jan 8, 2008

Last updated

Jul 30, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Richard S Goldman, MD

Title

Owner

Phone

(781) 416-5200

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Richard s. Goldman Former legal business name

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

{
    "created_epoch": "1199750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217376000000",
    "number": "1922283076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "873 WORCESTER ST",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024823714",
            "telephone_number": "781-416-5200",
            "fax_number": "781-416-0956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "873 WORCESTER ST",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024823714",
            "telephone_number": "781-416-5200",
            "fax_number": "781-416-0956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCESS MD",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-08",
        "last_updated": "2008-07-30",
        "status": "A",
        "authorized_official_last_name": "GOLDMAN",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-416-5200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "MA",
            "license": "56153",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3019217",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Richard s. Goldman",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Exclusive Provider Organization in Wellesley, MA
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• Exclusive Provider Organization in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; 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.