PREVENTIVE MEDICINE ASSOCIATES (NPI# 1871759498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871759498 |
| Entity Type | Organization |
| Organization Name | PREVENTIVE MEDICINE ASSOCIATES |
| Other Organization Name | BOSTON FAMILY PRACTICE |
| Practice Address |
59 Temple Pl Suite 664 Boston MA 02111-1307 |
| Practice Telephone | 6175427860 |
| Mailing Telephone | 6175427860 |
| Enumeration Date | 2008-08-03 |
| Last Update Date | 2008-08-03 |
| Authorized Official Name | MS. MARY J DELONG (CREDENTIALING MANAGER) |
| Authorized Official Telephone | 4132227711 |
| Authorized Official Credential | MM, RHIA |
| Is Organization Subpart | Y |
| Parent Organization Name | PREVENTIVE MEDICINE ASSOCIATES |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Boston Family Practice | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528353612 | Preventive Medicine Associates | Family Medicine | 154 Lynnway, Suite 1c, Lynn, MA 01902-3479 | 2011-06-16 |
| 1659679793 | Preventive Medicine Associates | Family Medicine | 2201 Washington St, Suite 302, Roxbury, MA 02119-3212 | 2011-03-13 |
| 1568760601 | Preventive Medicine Associates | Family Medicine | 501b Washington St, Dorchester Center, MA 02124-2014 | 2011-03-13 |
| 1962705251 | Preventive Medicine Associates | Family Medicine | 9 Henshaw St, Brighton, MA 02135-2905 | 2010-12-08 |
| 1326350976 | Preventive Medicine Associates | Family Medicine | 360 Coggeshall St, New Bedford, MA 02746-1923 | 2010-07-12 |
| 1689900565 | Preventive Medicine Associates | Family Medicine | 322 Gifford St, Falmouth, MA 02540 | 2009-10-27 |
| 1962641159 | Preventive Medicine Associates | Family Medicine | 63 Winthrop St, # C1, C2, Taunton, MA 02780-6218 | 2009-02-11 |
| 1578702957 | Preventive Medicine Associates | Counselor | 3261 Main St, Barnstable, MA 02630-1105 | 2009-02-09 |
| 1356507511 | Preventive Medicine Associates | Family Medicine | 98 Suffolk St, Holyoke, MA 01040-4458 | 2008-08-06 |
| 1588093744 | Preventive Medicine Associates | Specialist | 1919 Sw 10th Ave, Suite 22, Topeka, KS 66604-1425 | 2013-11-07 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | PREVENTIVE MEDICINE ASSOCIATES, INC. | 59 Temple Place, Suite 612, Boston, MA 02111 |
| Street Address |
59 TEMPLE PL SUITE 664 |
| City | BOSTON |
| State | MA |
| Zip Code | 02111-1307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245287903 | Sabrina M Popp | Psychiatry & Neurology | 59 Temple Pl, Suite 223, Boston, MA 02111-1307 | 2006-05-28 |
| 1053529040 | John R. Raftery | Pediatrics | 59 Temple Pl, Suite 1106, Boston, MA 02111-1307 | 2007-05-21 |
| 1407998917 | Jaimie Deborah Champagne | Acupuncturist | 59 Temple Pl, Suite 223, Boston, MA 02111-1307 | 2007-02-12 |
| 1164574257 | Edward F Mclaughlin | Psychologist | 59 Temple Pl, Suite 400, Boston, MA 02111-1307 | 2007-01-17 |
| 1063562320 | John V. Pruitt IIi | Psychiatry & Neurology | 59 Temple Pl, Ste 400, Boston, MA 02111-1307 | 2007-01-11 |
| 1568474385 | Brett Phillip Terrien | Counselor | 59 Temple Pl, Suite 300, Boston, MA 02111-1307 | 2006-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689271397 | Maximilian Richert | Counselor | 25 Kingston St, 4r, Boston, MA 02111 | 2020-10-06 |
| 1558978957 | Tien-hsin Chang | Student in an Organized Health Care Education/Training Program | 1 Kneeland Street (tufts University School of Dental Me, Boston, MA 02111 | 2020-09-29 |
| 1548883465 | Elizabeth Carter Stapleton | Dentist | Tufts School of Dental Medicine: Dept of Orthodontics, 1 Kneeland Street, Boston, MA 02111 | 2020-05-27 |
| 1932729597 | Jacob Joseph Kosarchuk | Neurological Surgery | 800 Washington Street, Proger 7, Boston, MA 02111 | 2020-04-23 |
| 1164051868 | Daniele Abela | Surgery | 860 Washington Street, South Building, 4th Floor, Boston, MA 02111 | 2020-04-04 |
| 1184265258 | Jade Orthodontics | Dentist | 30 Kneeland St, Suite 301, Boston, MA 02111 | 2019-09-30 |
| 1932753639 | Loukia Kamille Danaf | Student in an Organized Health Care Education/Training Program | 1 Kneeland Street, Tufts University School of Dental Me, Boston, MA 02111 | 2019-07-31 |
| 1033771944 | Faris Khalifa | Student in an Organized Health Care Education/Training Program | 1 Kneeland Street, 5th Floor, Boston, MA 02111 | 2019-07-01 |
| 1609437276 | Blair Hanna Ray Farbstein | Student in an Organized Health Care Education/Training Program | 1 Kneeland Street, 3rd Floor, Boston, MA 02111 | 2019-06-25 |
| 1821658709 | Jennifer Drummond | Internal Medicine | 800 Washington St. Gme Office, Boston, MA 02111 | 2019-06-13 |
| Find all providers in zip 02111 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851746739 | Tamara Itzel Martinez | Family Medicine | 300 Longwood Ave, Boston, MA 02115-5724 | 2016-04-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578062758 | Robynne Brown | Family Medicine | 59 Coddington St Ste 103, Quincy, MA 02169-4510 | 2018-02-02 |
| 1528353612 | Preventive Medicine Associates | Family Medicine | 154 Lynnway, Suite 1c, Lynn, MA 01902-3479 | 2011-06-16 |
| 1659679793 | Preventive Medicine Associates | Family Medicine | 2201 Washington St, Suite 302, Roxbury, MA 02119-3212 | 2011-03-13 |
| 1568760601 | Preventive Medicine Associates | Family Medicine | 501b Washington St, Dorchester Center, MA 02124-2014 | 2011-03-13 |
| 1962705251 | Preventive Medicine Associates | Family Medicine | 9 Henshaw St, Brighton, MA 02135-2905 | 2010-12-08 |
| 1326350976 | Preventive Medicine Associates | Family Medicine | 360 Coggeshall St, New Bedford, MA 02746-1923 | 2010-07-12 |
| 1689900565 | Preventive Medicine Associates | Family Medicine | 322 Gifford St, Falmouth, MA 02540 | 2009-10-27 |
| 1962641159 | Preventive Medicine Associates | Family Medicine | 63 Winthrop St, # C1, C2, Taunton, MA 02780-6218 | 2009-02-11 |
| 1356507511 | Preventive Medicine Associates | Family Medicine | 98 Suffolk St, Holyoke, MA 01040-4458 | 2008-08-06 |
| 1194949073 | Vineyard Healthcare Assoc. | Family Medicine | 455 State Rd Ste 13, Vineyard Haven, MA 02568-5621 | 2007-04-12 |
| 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.