NPIMap

Organization Active NPI

TLC Pediatrics PC

  • Pediatric Adolescent Medicine Physician
  • Revere, MA
National Provider Identifier
1962708271
Registry record updated Jul 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
Legal business name
TLC PEDIATRICS PC
Practice address
280 Beach St
Revere, MA 02151-3143
Phone
(781) 289-5057
Fax
(781) 289-4485
NPI assigned
Feb 3, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2020

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

Authorized official

Name
Dr. Janet Tieng Chua, M.D.NPI 1750388419
Title
President
Phone
(781) 289-5057

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
Pediatric Adolescent Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2080A0000X Primary

Addresses

Primary practice location

280 Beach St
Revere, MA 02151-3143

Mailing address

280 Beach St
Revere, MA 02151-3143
Phone (781) 289-5057

Other names 1

  • Revere-Winthrop Pediatrics Doing business as

National Provider Directory

National Provider Directory
Tax ID family
TLC Pediatrics PC2 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.

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 3

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": "1296691200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594252800000",
    "number": "1962708271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "280 BEACH ST",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021513143",
            "telephone_number": "781-289-5057",
            "fax_number": "781-289-4485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "280 BEACH ST",
            "city": "REVERE",
            "state": "MA",
            "postal_code": "021513143",
            "telephone_number": "781-289-5057",
            "fax_number": "781-289-4485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TLC PEDIATRICS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-03",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A",
        "authorized_official_last_name": "CHUA",
        "authorized_official_first_name": "JANET",
        "authorized_official_middle_name": "TIENG",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-289-5057",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Revere-Winthrop Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Revere-Winthrop Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Revere, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.