1477832780 NPI number — COMMUNITY PHYSICIANS ASSOCIATES, INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477832780 NPI number — COMMUNITY PHYSICIANS ASSOCIATES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
COMMUNITY PHYSICIANS ASSOCIATES, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1477832780
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/16/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
199 REEDSDALE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MILTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02186-3926
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-313-1907
Provider Business Mailing Address Fax Number:
617-313-1565

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
199 REEDSDALE ROAD
Provider Second Line Business Practice Location Address:
CENTER FOR ORTHOPAEDIC CARE - BIDMC MILTON
Provider Business Practice Location Address City Name:
MILTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02186-3881
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-313-1445
Provider Business Practice Location Address Fax Number:
617-313-1479
Provider Enumeration Date:
08/04/2011

Additional Information

Authorized Official

Authorized Official Last Name:
RANGAVIZ
Authorized Official First Name:
SHEILAH
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
617-313-1350

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  246949 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 110072296 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".




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