NPIMap

Organization Active NPI

Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Brockton, MA
National Provider Identifier
1932942869
Registry record updated Jun 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
CONVENIENTMD - FFS UC LLC
Practice address
1285 Belmont St Ste 1
Brockton, MA 02301-4440
Phone
(508) 894-7015
Fax
(508) 894-7861
NPI assigned
Jun 18, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2024

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

Authorized official

Name
Jarod Boissonneault
Title
VP, Revenue Cycle MGT
Phone
(603) 410-6700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

1285 Belmont St Ste 1
Brockton, MA 02301-4440

Mailing address

360 US Highway 1 Byp Unit 102
Portsmouth, NH 03801-7105
Phone (603) 410-6700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230921002173 MA Part B Supplier - Clinic/Group Practice 5193186492 Receives reassigned benefits from 310 practitioners
24 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: North Andover, MA; Peabody, MA; Pembroke, MA; Pittsfield, MA; Plainville, MA; Plymouth, MA; Quincy, MA; Saugus, MA…

Other NPIs on the same Medicare enrollment 24

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

View all 24

National Provider Directory

National Provider Directory

Locations

1285 Belmont St
Ste 1
Brockton, MA 02301
Phone (508) 894-7015

1285 Belmont St
Brockton, MA 02301

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1718668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718668800000",
    "number": "1932942869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 US HIGHWAY 1 BYP UNIT 102",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017105",
            "telephone_number": "603-410-6700",
            "fax_number": "603-319-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 BELMONT ST STE 1",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014440",
            "telephone_number": "508-894-7015",
            "fax_number": "508-894-7861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONVENIENTMD - FFS UC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-18",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A",
        "authorized_official_last_name": "BOISSONNEAULT",
        "authorized_official_first_name": "JAROD",
        "authorized_official_title_or_position": "VP, REVENUE CYCLE MGT",
        "authorized_official_telephone_number": "603-410-6700"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 18, 2024; 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.