1912179870 NPI number — CIRCLE HEALTH OBGYN, LLC.

Table of content: (NPI 1912179870)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912179870 NPI number — CIRCLE HEALTH OBGYN, LLC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CIRCLE HEALTH OBGYN, LLC.
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:
1912179870
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/10/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20 RESEARCH PL STE 320
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH CHELMSFORD
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01863-2455
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
978-256-1858
Provider Business Mailing Address Fax Number:
978-788-7890

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20 RESEARCH PL STE 320
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH CHELMSFORD
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01863-2455
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
978-256-1858
Provider Business Practice Location Address Fax Number:
978-788-7890
Provider Enumeration Date:
03/31/2008

Additional Information

Authorized Official

Authorized Official Last Name:
WYMAN
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
F.
Authorized Official Title or Position:
SR. VICE PRESIDENT OF FINANCE
Authorized Official Telephone Number:
978-937-6034

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0005394 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1912179870 . This is a "BCBS OF MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1912179870 . This is a "HEALTHNET OF CA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1912179870 . This is a "HEALTHSOURCE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 9737821 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0005394 . This is a "MEDICARE PTAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1912179870 . This is a "CHAMPUS TRICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1912179870 . This is a "PHCS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1912179870 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1912179870 . This is a "CIGNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1912179870 . This is a "HEALTH PLANS INC" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1912179870 . This is a "NETWORK HEALTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1912179870 . This is a "AETNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1912179870 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1912179870 . This is a "GREAT WEST" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1912179870 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1912179870 . This is a "HARVARD PILGRIM HEALTH CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1912179870 . This is a "BMC HEALTH NET" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1912179870 . This is a "CHOICECARE NETWORK (HUMANA)" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1912179870 . This is a "FALLON" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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