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 |
| 1 | 282NC0060X | General Acute Care Hospital | Critical Access | 2052 | MASSACHUSETTS | No |
| 2 | 275N00000X | Medicare Defined Swing Bed Unit | | 2052 | MASSACHUSETTS | Yes |
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 |
| 1 | 905627 | OTHER | | TUFTS HEALTH PLAN INPT |
| 2 | 2222003810 | OTHER | MASSACHUSETTS | BLUE CROSS OUTPT |
| 3 | 900038 | OTHER | | HARVARD PILGRIM HEALTH |
| 4 | 992756 | OTHER | | CONNECTICARE |
| 5 | 220038 | OTHER | MASSACHUSETTS | UNICARE MA EMPLOYEE GIC |
| 6 | 1001728 | MEDICAID | MASSACHUSETTS | |
| 7 | 10005803 | OTHER | | CDPHP |
| 8 | HO4359 | OTHER | | OXFORD |
| 9 | 1200542 | MEDICAID | MASSACHUSETTS | |
| 10 | 2222003801 | OTHER | MASSACHUSETTS | BLUE CROSS INPT |
| 11 | 0373 | OTHER | | MVP |
| 12 | 2222003830 | OTHER | MASSACHUSETTS | BLUE CROSS SDC |
| 13 | 6300460 | OTHER | | AETNA |
| 14 | 12257 | OTHER | | HEALTH NEW ENGLAND |
| 15 | 20850 | OTHER | MASSACHUSETTS | BMC HEALTH NET PLAN |
| 16 | 221302 | OTHER | | HUMANA |
| 17 | 900245 | OTHER | | TUFTS HEALTH PLAN OUTPT |
| 18 | 22Z302 | MEDICARE OSCAR/CERTIFICATION | MASSACHUSETTS | |
