Active NPI
Charles River Urology Inc
- Urology Physician
- Boston, MA
National Provider Identifier
1982690731
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Urology Physician
- License
- 29066
- Legal business name
- CHARLES RIVER UROLOGY INC
- Practice address
- 15 Parkman St
Suite 486
Boston, MA 02114-3117 - Phone
- (617) 726-3512
- Fax
- (617) 726-3519
- NPI assigned
- Sep 26, 2005
- Last updated
- May 22, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Stephen P Dretler, M.D.
- Title
- President
- Phone
- (617) 726-3512
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Urology Physician | 208800000X | 29066 | MA | Primary |
Addresses
Primary practice location
15 Parkman St
Suite 486
Boston, MA 02114-3117
Mailing address
15 Parkman St
Suite 486
Boston, MA 02114-3117
Phone (617) 726-3512
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9708979 | Medicaid | MA |
National Provider Directory
National Provider DirectoryLocations
15 Parkman St
Ste 486
Boston, MA 02114
Phone (617) 726-3512
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127692800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1337644800000",
"number": "1982690731",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15 PARKMAN ST",
"address_2": "SUITE 486",
"city": "BOSTON",
"state": "MA",
"postal_code": "021143117",
"telephone_number": "617-726-3512",
"fax_number": "617-726-3519"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 PARKMAN ST",
"address_2": "SUITE 486",
"city": "BOSTON",
"state": "MA",
"postal_code": "021143117",
"telephone_number": "617-726-3512",
"fax_number": "617-726-3519"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CHARLES RIVER UROLOGY INC",
"organizational_subpart": "NO",
"enumeration_date": "2005-09-26",
"last_updated": "2012-05-22",
"status": "A",
"authorized_official_last_name": "DRETLER",
"authorized_official_first_name": "STEPHEN",
"authorized_official_middle_name": "P",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "617-726-3512",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "208800000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Urology",
"state": "MA",
"license": "29066",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9708979",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Boston, MA
- Bianka Maria Charity-Parker, M.ED.
- Marissa Charland
- Charles a Boucher MD PC
- Charles River Dental Associates, PC
- Charles River Eye Associates (Jack V Greiner DBA Charles River Eye Associates)
- Charles Street Eyecare LLC
- Charles Street Family Chiropractic, Inc
- Charles Street Family Chiropractic, Inc.
- Charles Trey M D & Associates P C
- Antoinette Jasmine Charles
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.