NPIMap

Organization Active NPI

Allied Pediatrics of Greater Brockton Inc.

  • Pediatrics Physician
  • Brockton, MA
National Provider Identifier
1942301239
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
ALLIED PEDIATRICS OF GREATER BROCKTON INC.
Practice address
179 Quincy St
Brockton, MA 02302-2966
Phone
(508) 427-7700
NPI assigned
Sep 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. David Alvarez, MD
Title
Vice President
Phone
(508) 427-7700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

179 Quincy St
Brockton, MA 02302-2966

Mailing address

179 Quincy St
Brockton, MA 02302-2966
Phone (508) 427-7700

Other identifiers 2

IdentifierTypeStateIssuer
9780122MedicaidMA
M16595OtherMABLUE CROSS GROUP NUMBER

National Provider Directory

National Provider Directory

Locations

179 Quincy St
Brockton, MA 02302
Phone (508) 427-7700

NPI Registry JSON

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

{
    "created_epoch": "1159228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1942301239",
    "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": "023022966",
            "telephone_number": "508-427-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "179 QUINCY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023022966",
            "telephone_number": "508-427-7700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLIED PEDIATRICS OF GREATER BROCKTON INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ALVAREZ",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "508-427-7700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9780122",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GROUP NUMBER",
            "identifier": "M16595",
            "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 Aug 22, 2020; 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.