Prusty Endocrine Associates

Primary specialty

SpecialistTaxonomy code 174400000X

License

228973 Issued in MA

Legal business name

PRUSTY ENDOCRINE ASSOCIATES

Practice address

571 Main St
Second Floor
South Weymouth, MA 02190-1843

Phone

(617) 335-9363

NPI assigned

Oct 22, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Deepanwita Prusty, M.D.NPI 1861473514

Title

Owner

Phone

(617) 335-9363

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Locations

Practitioners 1

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

• Deepanwita Prusty, MD PHD

  • Specialist
  • South Weymouth, MA
  • NPI 1861473514
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1445472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445472000000",
    "number": "1982076535",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "571 MAIN ST",
            "address_2": "SECOND FLOOR",
            "city": "SOUTH WEYMOUTH",
            "state": "MA",
            "postal_code": "021901843",
            "telephone_number": "617-335-9363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "571 MAIN ST",
            "address_2": "SECOND FLOOR",
            "city": "SOUTH WEYMOUTH",
            "state": "MA",
            "postal_code": "021901843",
            "telephone_number": "617-335-9363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUSTY ENDOCRINE ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-22",
        "last_updated": "2015-10-22",
        "status": "A",
        "authorized_official_last_name": "PRUSTY",
        "authorized_official_first_name": "DEEPANWITA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-335-9363",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MA",
            "license": "228973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "11078614A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Anne Powderly
• Liam Power
• William Davenport Powlis, M.D.
• Ori Preis, M.D.
• Ann-Gael Deborrah Privert, M.D.
• Deepanwita Prusty, MD PHD
• Devin Quinn
• Afreen Rahman, M.ED
• Rebecca Ramirez-McKinely, MS, LAT, ATC, CSCS,
• Carissa C Rand, PHYSICIAN ASSISTANT

• Specialist in South Weymouth, MA
• Providers in South Weymouth, MA by specialty
• Specialist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2015; 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.