NPIMap

Organization Active NPI

Pediatric Associates of Malden PC

  • Pediatrics Physician
  • Malden, MA
National Provider Identifier
1942378633
Registry record updated Jul 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
PEDIATRIC ASSOCIATES OF MALDEN PC
Practice address
105 Commercial St
Malden, MA 02148-5509
Phone
(781) 322-5101
Fax
(781) 322-5820
NPI assigned
Dec 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2008

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

Authorized official

Name
Tien Lan Chang, MDNPI 1255313771
Title
President
Phone
(781) 322-5101

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
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

105 Commercial St
Malden, MA 02148-5509

Mailing address

105 Commercial St
Malden, MA 02148-5509
Phone (781) 322-5101

Other identifiers 3

IdentifierTypeStateIssuer
M17324OtherMABCBS
683054OtherMATUFFY HEALTH PLAN
9785973MedicaidMA

National Provider Directory

National Provider Directory
Tax ID family
Pediatric Associates of Malden2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

105 Commercial St
Malden, MA 02148
Phone (781) 322-5101

Practitioners & affiliated clinicians

Practitioners 7

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": "1164931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217462400000",
    "number": "1942378633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 COMMERCIAL ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021485509",
            "telephone_number": "781-322-5101",
            "fax_number": "781-322-5820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 COMMERCIAL ST",
            "city": "MALDEN",
            "state": "MA",
            "postal_code": "021485509",
            "telephone_number": "781-322-5101",
            "fax_number": "781-322-5820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC ASSOCIATES OF MALDEN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-01",
        "last_updated": "2008-07-31",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "TIEN LAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-322-5101",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "M17324",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFFY HEALTH PLAN",
            "identifier": "683054",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9785973",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Malden, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 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.