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WEBSTER SQUARE MEDICAL CENTER INC NPI 1619188281


NPI Information

NPI: 1619188281
Provider Name: WEBSTER SQUARE MEDICAL CENTER, INC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 22D0069533

Address:
255 PARK AVE
SUITE 400
WORCESTER, MA
ZIP 01609
Phone: (508) 755-9776
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WEBSTER SQUARE MEDICAL CENTER, INC is an internal medicine in Worcester, MA. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. WEBSTER SQUARE MEDICAL CENTER, INC NPI is 1619188281. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

255 PARK AVE
SUITE 400
WORCESTER, MA
ZIP 01609-953
Phone: (508) 755-9776
Fax: (508) 793-0715

The provider's authorized official is Walter Keaton Goljan .
The authorized official title is President and has the following contact phone number (508) 755-9776.

The CLIA number assigned to this NPI record is 22D0069533 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/25/2007 and was last updated on 2/21/2012.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal Medicine52685MASSACHUSETTSYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1P48371MEDICARE UPINMASSACHUSETTS
29768939MEDICAIDMASSACHUSETTS
3AP2405MEDICARE ID-TYPE UNSPECIFIEDMASSACHUSETTS
4Z096803MEDICAIDMASSACHUSETTS
5N01866MEDICARE ID-TYPE UNSPECIFIEDMASSACHUSETTS
6M15631MEDICARE ID-TYPE UNSPECIFIEDMASSACHUSETTS
7A87185MEDICARE UPINMASSACHUSETTS
8B99089MEDICARE UPINMASSACHUSETTS
9NP4997MEDICARE ID-TYPE UNSPECIFIEDMASSACHUSETTS
10Q42225MEDICARE UPINMASSACHUSETTS

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.