PRIMARY CARE PEDIATRICS NPI 1700203767

NPI Information

  • NPI: 1700203767
  • Provider Name: PRIMARY CARE PEDIATRICS
  • Classification: Pediatrics - 208000000X
  • Entity Type: Organization
  • CLIA Number: 22D1088788
  • Address: 25 WALNUT ST
    SUITE 102
    WELLESLEY, MA
    ZIP 02481
  • Phone: (617) 977-3057

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NPI Details

PRIMARY CARE PEDIATRICS is a pediatrics in Wellesley, 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. PRIMARY CARE PEDIATRICS NPI is 1700203767. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

25 WALNUT ST
SUITE 102
WELLESLEY, MA
ZIP 02481-152
Phone: (617) 977-3057
Fax: (617) 467-5318

The provider's authorized official is Terry Amirto .
The authorized official title is Billing Manager and has the following contact phone number (978) 944-0337.

The CLIA number assigned to this NPI record is 22D1088788 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/27/2014 and was last updated on 3/27/2014.

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
1208000000XPediatrics32752MASSACHUSETTSYes

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
19782044MEDICAIDMASSACHUSETTS

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: 11/21/2025

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