SOUTHCOAST PHYSICIANS GROUP, INC. (NPI# 1336137629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336137629 |
| Entity Type | Organization |
| Organization Name | SOUTHCOAST PHYSICIANS GROUP, INC. |
| Other Organization Name | SOUTHCOAST PHYSICIAN SERVICES, INC. |
| Practice Address |
200 Mill Road Suite 180 Fairhaven MA 02719-5252 |
| Practice Telephone | 5089732000 |
| Practice Fax Number | 5089732001 |
| Mailing Telephone | 5089732000 |
| Mailing Fax Number | 5089732001 |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2019-06-28 |
| Authorized Official Name | MELISSA ROSE (SHS VICE PRESIDENT OF CONTRACTING) |
| Authorized Official Telephone | 5089732950 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 208M00000X | Hospitalist | Allopathic & Osteopathic Physicians | ||
| N | 261QU0200X |
Clinic/Center Specialization: Urgent Care |
Ambulatory Health Care Facilities | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| RI | BM11666 | 05 | |
| MA | RAILROAD MEDICARE | CN5678 | 01 |
| MA | MEDICARE PIN | M20518 | 01 |
| RI | SP28498 | 05 | |
| RI | BM20689 | 05 | |
| MA | 9779752 | 05 | |
| MA | RAILROAD MEDICARE | CD2506 | 01 |
| MA | RAILROAD MEDICARE | CG4450 | 01 |
| MA | BCBS MASSACHUSETTS | M16989 | 01 |
| Other Name | Type Code |
|---|---|
| Southcoast Physician Services, Inc. | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841787652 | Southcoast Physicians Group, Inc. | Family Medicine | 670 Aquidneck Avenue, Middletown, RI 02841 | 2018-04-17 |
| 1770090870 | Southcoast Physicians Group, Inc. | Family Medicine | 636 County St, Taunton, MA 02780-3604 | 2018-01-10 |
| 1235646332 | Southcoast Physicians Group, Inc. | Family Medicine | 374 William S Canning Blvd, Fall River, MA 02721-2352 | 2018-01-10 |
| 1134664253 | Southcoast Physicians Group, Inc. | Family Medicine | 435 State Rd, Unit F, North Dartmouth, MA 02747-4306 | 2016-12-28 |
| 1306381421 | Southcoast Physicians Group, Inc. | Family Medicine | 37 Commerce Way, Seekonk, MA 02771-5816 | 2016-12-28 |
| 1750869681 | Southcoast Physicians Group, Inc. | Audiologist | 200 Mill Rd Ste 180, Fairhaven, MA 02719-5255 | 2018-08-02 |
| 1700393808 | Southcoast Physicians Group, Inc. | Family Medicine | 12 Main St, Lakeville, MA 02347-1606 | 2018-01-10 |
| 1619413150 | Southcoast Physicians Group, Inc. | Family Medicine | 2421 Cranberry Hwy, Wareham, MA 02571-5021 | 2017-01-09 |
| 1346634052 | Southcoast Physicians Group, Inc. | Internal Medicine | 1030 President Ave, Suite 110, Fall River, MA 02720-5923 | 2015-03-20 |
| 1225421118 | Southcoast Physicians Group, Inc. | Physical Therapist | 479 Swansea Mall Dr, Swansea, MA 02777-4119 | 2015-03-17 |
| Street Address |
200 MILL ROAD SUITE 180 |
| City | FAIRHAVEN |
| State | MA |
| Zip Code | 02719-5252 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861808453 | Ashley C Paiva | Nurse Practitioner | 200 Mill Road, Suite 190, Fairhaven, MA 02719-5255 | 2014-07-03 |
| 1558794651 | Kimberly Ann Moniz | Nurse Practitioner | 200 Mill Road, Suite 180, Fairhaven, MA 02719 | 2013-08-13 |
| 1649318288 | Susan Lynne Debalsi | Physician Assistant | 200 Mill Road, Suite 190, Fairhaven, MA 02719 | 2007-02-04 |
| 1861411449 | Susan Wareing | Nurse Practitioner | 200 Mill Road, Suite 180, Fairhaven, MA 02719 | 2006-07-18 |
| 1477522290 | Chandra S Reddivari | Internal Medicine | 200 Mill Road, Suite 190, Fairhaven, MA 02719-5252 | 2006-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457589772 | David Paul Patterson | Nurse Practitioner | 271 Alden Rd, Fairhaven, MA 02719 | 2009-06-25 |
| 1245415983 | Carol Ann Reeve | Social Worker | 21 Nelson Ave, Fairhaven, MA 02719 | 2007-12-31 |
| 1194842716 | Cathleen Lacy | Physical Therapist | 333 Bridge St, Fairhaven, MA 02719 | 2007-03-26 |
| 1700903978 | Barbara Ann Acksen | Psychologist | 91 Green Street, Fairhaven, MA 02719 | 2007-03-23 |
| 1811023260 | Merolla Chiropractic Inc | Chiropractor | 73 Alden Rd, Fairhaven, MA 02719 | 2007-02-27 |
| 1982746442 | Michele E Merolla | Chiropractor | 73 Aiden Rd, Fairhaven, MA 02719 | 2007-02-13 |
| 1417016338 | Brian K Bowcock | Chiropractor | 84 Huttleston Avenue, Fairhaven, MA 02719 | 2006-12-06 |
| 1104937697 | Southcoast Visiting Nurse Association. Inc | Home Health | 200 Mill Road, Suite 120, Fairhaven, MA 02719 | 2006-08-31 |
| 1902817299 | 184 Main LLC | Skilled Nursing Facility | 184 Main Street, Fairhaven, MA 02719 | 2006-08-11 |
| 1821584103 | Smiley Dental Care Pllc | Clinic/Center | 17 Berdon Way, Fairheaven, MA 02719 | 2018-07-10 |
| Find all providers in zip 02719 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639153596 | Sandra Diane Johnson | Family Medicine | 208 Mill Road, Fairhaven, MA 02719-5252 | 2005-12-05 |
| 1477930881 | Jaimie L. Reed | Family Medicine | 208 Mill Rd, Fairhaven, MA 02719-5208 | 2015-05-05 |
| 1023422607 | Kevin Raymond Gendreau | Family Medicine | 208 Mill Rd, Fairhaven, MA 02719-5208 | 2014-06-11 |
| 1538398326 | Tristan Medical Enterprises PC | Family Medicine | 210 Washington St, Fairhaven, MA 02719-4044 | 2009-07-14 |
| 1073748893 | Valentina Dacunha | Family Medicine | 208 Mill Rd, Fairhaven, MA 02719-5208 | 2009-05-22 |
| 1114914181 | Joseph A Costa | Family Medicine | 208 Mill Rd, Fairhaven, MA 02719-5208 | 2005-10-04 |
| 1518954650 | Drew L Nahigyan | Family Medicine | 208 Mill Rd, Fairhaven, MA 02719-5208 | 2005-10-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457966806 | Eliana Decastro Cuellar | Family Medicine | 1030 President Ave Ste 1001, Fall River, MA 02720-5923 | 2020-09-12 |
| 1386260594 | Form Health Associates (ma), P.C. | Family Medicine | 179 Lincoln St Ste 404, Boston, MA 02111-2425 | 2020-06-23 |
| 1043835044 | Form Health Associates, P.C. | Family Medicine | 179 Lincoln St Fl 4, Boston, MA 02111-2424 | 2020-06-15 |
| 1588290324 | Lighthouse Primary Care PC | Family Medicine | 315 Main St Ste 101, North Reading, MA 01864-1326 | 2020-03-12 |
| 1730714106 | Berkshire Whole Health PC | Family Medicine | 8 Pine St, Stockbridge, MA 01262-9706 | 2020-03-06 |
| 1578100889 | Kelly Ramappa | Family Medicine | 96 Temple St, West Newton, MA 02465-2307 | 2019-12-05 |
| 1295372787 | Julie A Gil | Family Medicine | 114b Lelandville Rd, Charlton, MA 01507-6714 | 2019-12-04 |
| 1154962942 | Molly Rose Lodigiani | Family Medicine | 275 Cypress St Apt 105, Brookline, MA 02445-6774 | 2019-10-02 |
| 1699316539 | Luisa Alejandra Centeno Silva | Family Medicine | 4785 Washington St # 2, West Roxbury, MA 02132-2113 | 2019-10-02 |
| 1609427962 | Jessica Blanchard | Family Medicine | 100 Leominster Rd, Sterling, MA 01564-2156 | 2019-09-26 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.