Organization Active NPI

Marilyn R Capek MD PC

  • Dermatology Physician
  • Winchester, MA
National Provider Identifier
1982871893
Registry record updated Nov 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
45920 Issued in MA
Legal business name
MARILYN R CAPEK MD PC
Practice address
955 Main St
Suite 308
Winchester, MA 01890-1961
Phone
(781) 729-3150
Fax
(781) 721-6173
NPI assigned
May 9, 2008
Last updated
Nov 24, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2015

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

Authorized official

Name
Marilyn CapekNPI 1992848469
Title
Billing Coordinator
Phone
(781) 729-3150

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
Dermatology Physician 207N00000X 45920 MA Primary

Addresses

Primary practice location

955 Main St
Suite 308
Winchester, MA 01890-1961

Mailing address

955 Main St
Suite 308
Winchester, MA 01890-1961
Phone (781) 729-3150

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080820000389 MA Part B Supplier - Clinic/Group Practice 6305911736 Receives reassigned benefits from 1 practitioner
Practice locations: Winchester, MA

National Provider Directory

National Provider Directory

Locations

955 Main St
Ste 308
Winchester, MA 01890
Phone (781) 729-3150

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1210291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1448323200000",
    "number": "1982871893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "955 MAIN ST",
            "address_2": "SUITE 308",
            "city": "WINCHESTER",
            "state": "MA",
            "postal_code": "018901961",
            "telephone_number": "781-729-3150",
            "fax_number": "781-721-6173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "955 MAIN ST",
            "address_2": "SUITE 308",
            "city": "WINCHESTER",
            "state": "MA",
            "postal_code": "018901961",
            "telephone_number": "781-729-3150",
            "fax_number": "781-721-6173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARILYN R CAPEK MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-09",
        "last_updated": "2015-11-24",
        "status": "A",
        "authorized_official_last_name": "CAPEK",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_title_or_position": "BILLING COORDINATOR",
        "authorized_official_telephone_number": "781-729-3150"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "MA",
            "license": "45920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winchester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.