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 | 207RI0200X | Internal Medicine | Infectious Disease | 29778 | 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 | N01562 | OTHER | | BLUE SHIELD INDEMNITY |
| 2 | 042472266 | OTHER | | ONE HEALTH PLAN |
| 3 | 440002603 | OTHER | | RAILROAD MEDICARE |
| 4 | 7221604 | OTHER | | AETNA US HEALTHCARE |
| 5 | 9900072 | OTHER | | FALLON COMMUNITY HEALTH |
| 6 | N01562 | OTHER | | BLUE SHIELD HMO BLUE |
| 7 | 7227566 | OTHER | | CIGNA HEALTH PLAN |
| 8 | 042472266 | OTHER | | PRIVATE HEALTHCARE SYSTEM |
| 9 | 26755 | OTHER | | CHILDRENS MEDICAL SECURIT |
| 10 | 0104051 | MEDICAID | MASSACHUSETTS | |
| 11 | N01562 | OTHER | | MEDICARE B |
| 12 | N01562 | OTHER | | BLUE CARE ELECT |
| 13 | D83080 | MEDICARE UPIN | | |
| 14 | 26755 | OTHER | | HEALTHY START |
| 15 | 783996 | OTHER | | MVP HEALTH CARE |
| 16 | 0104051 | OTHER | | MEDICAID WELFARE |
| 17 | N01562 | MEDICARE ID-TYPE UNSPECIFIED | MASSACHUSETTS | |
| 18 | 042472266 | OTHER | | HEALTHCARE VALUE MGMT |
| 19 | 934912 | OTHER | | FIRST HEALTH |
| 20 | AA4450 | OTHER | | HARVARD PILGRIM HEALTH |
