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 | 207RC0000X | Internal Medicine | Cardiovascular Disease | | | No |
| 2 | 207RC0001X | Internal Medicine | Clinical Cardiac Electrophysiology | | | No |
| 3 | 207RC0200X | Internal Medicine | Critical Care Medicine | | | No |
| 4 | 207RE0101X | Internal Medicine | Endocrinology, Diabetes & Metabolism | | | No |
| 5 | 207RG0100X | Internal Medicine | Gastroenterology | | | No |
| 6 | 207RH0000X | Internal Medicine | Hematology | | | No |
| 7 | 207RH0003X | Internal Medicine | Hematology & Oncology | | | No |
| 8 | 207RI0011X | Internal Medicine | Interventional Cardiology | | | No |
| 9 | 207RI0200X | Internal Medicine | Infectious Disease | | | No |
| 10 | 207RS0012X | Internal Medicine | Sleep Medicine | | | No |
| 11 | 207RP1001X | Internal Medicine | Pulmonary Disease | | | No |
| 12 | 207RG0300X | Internal Medicine | Geriatric Medicine | | | No |
| 13 | 207RN0300X | Internal Medicine | Nephrology | | | No |
| 14 | 207RA0201X | Internal Medicine | Allergy & Immunology | | | No |
| 15 | 207R00000X | Internal Medicine | | | | 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 | M20853 | MEDICARE ID-TYPE UNSPECIFIED | MASSACHUSETTS | MCARE MEDCARDIOLOGY GRP# |
| 2 | M20855 | MEDICARE ID-TYPE UNSPECIFIED | MASSACHUSETTS | MCARE MED INF DIS GRP # |
| 3 | M20850 | MEDICARE ID-TYPE UNSPECIFIED | MASSACHUSETTS | MCARE MED RHEUM GRP # |
| 4 | M20852 | MEDICARE ID-TYPE UNSPECIFIED | MASSACHUSETTS | MCARE MEDENDOCRINE GRP # |
| 5 | M20858 | MEDICARE ID-TYPE UNSPECIFIED | MASSACHUSETTS | MCARE MED RENAL GRP # |
| 6 | M20851 | MEDICARE ID-TYPE UNSPECIFIED | MASSACHUSETTS | MCARE MEDHEM GRP # |
| 7 | M20856 | MEDICARE ID-TYPE UNSPECIFIED | MASSACHUSETTS | MCARE MED INTMED GRP # |
| 8 | M20859 | MEDICARE ID-TYPE UNSPECIFIED | MASSACHUSETTS | MCARE MED PULMONARY GRP# |
| 9 | 9700111 | MEDICAID | MASSACHUSETTS | |
| 10 | M17354 | OTHER | MASSACHUSETTS | BCBS MEDICINE GRP # |
| 11 | M20854 | MEDICARE ID-TYPE UNSPECIFIED | MASSACHUSETTS | MCARE MEDGASTRO GRP # |