SOUTH SHORE PLASTIC SURGERY (NPI# 1770719676) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770719676 |
| Entity Type | Organization |
| Organization Name | SOUTH SHORE PLASTIC SURGERY |
| Other Organization Name | BOSTON PLASTIC SURGERY |
| Practice Address |
2300 Crown Colony Dr Suite 101 Quincy MA 02169-0902 |
| Practice Telephone | 6177867600 |
| Practice Fax Number | 6177867616 |
| Mailing Telephone | 6177867600 |
| Mailing Fax Number | 6177867616 |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2009-08-25 |
| Authorized Official Name | FOUAD J SAMAHA (PRESIDENT) |
| Authorized Official Telephone | 6177867600 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | HPHC | 21222 | 01 |
| MA | BLUE CROSS BLUE SHIELD | 1043212541 | 01 |
| Other Name | Type Code |
|---|---|
| Boston Plastic Surgery | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093701708 | South Shore Plastic Surgery | Plastic Surgery | 2300 Crown Colony Dr, Suite 101, Quincy, MA 02169-0902 | 2005-09-27 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | SOUTH SHORE PLASTIC SURGERY, INC. | 2100 Dorchester Ave., Ste 2201, Boston, MA 02124 |
| Street Address |
2300 CROWN COLONY DR SUITE 101 |
| City | QUINCY |
| State | MA |
| Zip Code | 02169-0902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043212541 | Fouad J Samaha | Plastic Surgery | 2300 Crown Colony Dr, Suite 101, Quincy, MA 02169-0902 | 2005-08-15 |
| 1952763385 | Meghan Harrington | Physical Medicine & Rehabilitation | 2300 Crown Colony Dr, 102, Quincy, MA 02169-0902 | 2016-03-24 |
| 1467712109 | Kate Cook | Nurse Practitioner | 2300 Crown Colony Dr, Suite 104, Quincy, MA 02169-0902 | 2012-05-28 |
| 1811934557 | Brian Max Berger | Obstetrics & Gynecology | 2300 Crown Colony Dr, Boston Ivf- The South Shore Center, Quincy, MA 02169-0902 | 2006-06-01 |
| 1902855976 | Diagnostic Health Corporation | Physiological Laboratory | 2300 Crown Colony Dr, Quincy, MA 02169-0902 | 2006-05-08 |
| 1093701708 | South Shore Plastic Surgery | Plastic Surgery | 2300 Crown Colony Dr, Suite 101, Quincy, MA 02169-0902 | 2005-09-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902427933 | Trinasia Jones | Counselor | 80 Quarry Street, 3, Quincy, MA 02169 | 2020-04-30 |
| 1164060778 | Bid-milton Physician Associates Inc | Clinic/Center | 100 Walter J. Hannon Pkwy, Quincy, MA 02169 | 2019-12-13 |
| 1669028064 | Renee Yvette Belisle | Occupational Therapist | 1266 Furnance Brook Parkway, Suite #100b, Quincy, MA 02169 | 2019-08-13 |
| 1952953713 | Phuc Thi Diem Ho | Registered Nurse | 18 Rustic Place, Quincy, MA 02169 | 2019-07-11 |
| 1518451939 | Lucille Jordan | Social Worker | 1175 Sea St, Quincy, MA 02169 | 2018-06-19 |
| 1326567447 | Tara Barney | Counselor | 290 Quarry Street Apt. 112, Quincy, MA 02169 | 2017-09-11 |
| 1295251007 | Iona Dental, P.C. (parent Organization) | Dentist | 10 Granite Street, Unit - 4c, Quincy, MA 02169 | 2017-08-15 |
| 1730610247 | Amy S. Chung | Family Medicine | 100 Walter J. Hannon Parkway, Quincy, MA 02169 | 2017-03-26 |
| 1205377314 | Wing Man Ting | Counselor | 2 Moon Island Road, Quincy, MA 02169 | 2017-03-09 |
| 1740726223 | Cameron James Dumas | Pharmacist | 21 23 Stanhope Street, Boston, MA 02169 | 2017-01-09 |
| Find all providers in zip 02169 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
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| 1851365415 | Quincy Physicians & Surgeons Clinic, Sc | Clinic/Center | 1118 Hampshire St, Quincy, IL 62301-3027 | 2006-02-13 |
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| 1477655801 | Cataract and Laser Center Associates PC | Clinic/Center | 1 Berkshire Sq, Suite 110, Adams, MA 01220-1300 | 2006-09-05 |
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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.