WINCHESTER PHYSICIAN ASSOCIATES NPI 1043293731

NPI Information

  • NPI: 1043293731
  • Provider Name: WINCHESTER PHYSICIAN ASSOCIATES
  • Classification: Pediatrics - 208000000X
  • Entity Type: Organization
  • Doing Business As: MYSTIC VALLEY PEDIATRICS
  • Address: 75 RIVERSIDE AVE
    2
    MEDFORD, MA
    ZIP 02155
  • Phone: (781) 391-8821

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NPI Details

WINCHESTER PHYSICIAN ASSOCIATES is a pediatrics in Medford, MA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. WINCHESTER PHYSICIAN ASSOCIATES NPI is 1043293731. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Mystic Valley Pediatrics.

The provider's business location address is:

75 RIVERSIDE AVE
2
MEDFORD, MA
ZIP 02155-600
Phone: (781) 391-8821
Fax: (781) 395-8798

The provider's authorized official is Eileen Wills .
The authorized official title is Billing Manager and has the following contact phone number (781) 756-7273.

The enumeration date for this NPI number is 11/28/2005 and was last updated on 3/20/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208000000XPediatrics73721MASSACHUSETTSNo
2208000000XPediatrics74993MASSACHUSETTSNo
3208000000XPediatrics73788MASSACHUSETTSYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1M20047MEDICARE PINMASSACHUSETTS
29777229MEDICAIDMASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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