SIGNATURE HEALTHCARE BROCKTON HOSPITAL
NPI 1174560304
Internal Medicine in Brockton, MA
NPI Status: Active since May 31, 2006
Contact Information
680 CENTRE ST
BROCKTON, MA
ZIP 02302
Phone: (508) 941-7062
Fax: (508) 941-6337
- Organization
- Internal Medicine
About SIGNATURE HEALTHCARE BROCKTON HOSPITAL
This page provides the complete NPI Profile along with additional information for Signature Healthcare Brockton Hospital, an internist established in Brockton, Massachusetts operating as a Internal Medicine. The healthcare provider is registered in the NPI registry with number 1174560304 assigned on May 2006. The practitioner's primary taxonomy code is 207R00000X. The provider is registered as an organization and their NPI record was last updated 16 years ago. Signature Healthcare Brockton Hospital operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The provider's is doing business as Signature Healthcare Brockton Hospital. The authorized official of this NPI record is Eugene C. Wallace (Ceo)
- NPI
- 1174560304
- Provider Legal Name
- BROCKTON HOSPITAL SPECIALTY PHYSICIAN GROUP
- Other Organization Name
- SIGNATURE HEALTHCARE BROCKTON HOSPITAL
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 680 CENTRE ST BROCKTON, MA 02302
- Location Phone
- (508) 941-7062
- Location Fax
- (508) 941-6337
- Mailing Address
- PO BOX 847493 BOSTON, MA 02284
- Mailing Phone
- (508) 565-0147
- Mailing Fax
- (508) 941-6337
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 05-31-2006
- Last Update Date
- 12-22-2009
- Code Navigator
An internist like Signature Healthcare Brockton Hospital is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Internal Medicine
- Taxonomy Code
- 207R00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | |
| 2 | 207LP2900X | Allopathic & Osteopathic Physicians | Anesthesiology | |
| 3 | 207P00000X | Allopathic & Osteopathic Physicians | Emergency Medicine | |
| 4 | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 5 | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 6 | 207RG0100X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 7 | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 8 | 207RR0500X | Allopathic & Osteopathic Physicians | Internal Medicine | |
| 9 | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | |
| 10 | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | |
| 11 | 208000000X | Allopathic & Osteopathic Physicians | Pediatrics | |
| 12 | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | |
| 13 | 208600000X | Allopathic & Osteopathic Physicians | Surgery | |
| 14 | 208M00000X | Allopathic & Osteopathic Physicians | Hospitalist |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 9757350 | MEDICAID (05) | MA | |
| M19115 | OTHER (01) | MA | BCBS GROUP # |
| M21752 | MEDICARE ID-TYPE UNSPECIFIED (04) | MA | GROUP # |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 7 | 4 | 5 | 6 | 0 | 3 | 0 | 4 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 14 | 4 | 10 | 6 | 0 | 3 | 0 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 1 + 4 + 4 + 1 + 0 + 6 + 0 + 3 + 0 + 24 = 46 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 50 - 46 = 4 | 4 | ||||||||
The NPI number 1174560304 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1649270182 | DR. SCHAHID RAWOOF MD Individual | Anesthesiology | 680 CENTRE ST BROCKTON, MA 02302 (508) 941-7642 |
| 1457344574 | JOHN MASHIKIAN MD Individual | Anesthesiology | 680 CENTRE ST BROCKTON, MA 02302 (401) 490-2130 |
| 1902873284 | DR. PETER J CRIMMINS PT, DPT Individual | Physical Therapist | 680 CENTRE ST BROCKTON, MA 02302 (508) 941-7242 |
| 1134187198 | DR. RENATE GIRARD M.D. Individual | Specialist | 680 CENTRE ST BROCKTON, MA 02302 (508) 941-7193 |
| 1104884022 | JEAN-PIERRE M. GEAGEA M.D. Individual | Internal Medicine (Interventional Cardiology) | 680 CENTRE ST BROCKTON, MA 02302 (508) 941-7700 |
| 1376592485 | DR. YEONIL CHOE MD Individual | Anesthesiology | 680 CENTRE ST ANESTHETICS OF BROCKTON, PC BROCKTON, MA 02302 (508) 941-7656 |
| 1396783742 | WOMEN'S HEALTH AFFILIATES, INC. Organization | Obstetrics & Gynecology | 680 CENTRE ST BROCKTON, MA 02302 (508) 941-7062 |
| 1538109061 | JOSE MARIO CORONA M.D. Individual | Emergency Medicine | 680 CENTRE ST BROCKTON, MA 02302 (508) 941-7400 |
| 1457395097 | ILENE E CARLSON MD Individual | Pathology (Anatomic Pathology & Clinical Pathology) | 680 CENTRE ST PATHOLOGY DEPARTMENT BROCKTON, MA 02302 (508) 941-7414 |
| 1366486904 | ROBERT F WRIGHT JR. MD Individual | Pathology (Anatomic Pathology & Clinical Pathology) | 680 CENTRE ST PATHOLOGY DEPARTMENT BROCKTON, MA 02302 (508) 941-7414 |
| 1083659726 | JITKA PERSINOVA MD Individual | Pathology (Anatomic Pathology & Clinical Pathology) | 680 CENTRE ST PATHOLOGY DEPARTMENT BROCKTON, MA 02302 (508) 941-7414 |
| 1811932395 | ELENA A VERBITSKY M.D. Individual | Psychiatry & Neurology (Psychiatry) | 680 CENTRE ST BROCKTON, MA 02302 (508) 941-7228 |
| 1861437170 | SHEILA LEFEVRE M.D. Individual | Anesthesiology | 680 CENTRE ST BROCKTON, MA 02302 (508) 941-7333 |
| 1225074123 | ANDREY GAGARIN M.D. Individual | Psychiatry & Neurology (Psychiatry) | 680 CENTRE ST BROCKTON, MA 02302 (508) 941-7228 |
| 1861429805 | DALE J ELLENBERG M.D. Individual | Internal Medicine | 680 CENTRE ST BROCKTON, MA 02302 (508) 941-7458 |
| 1013944792 | DR. DESIREE A CARLSON MD Individual | Pathology (Anatomic Pathology & Clinical Pathology) | 680 CENTRE ST PATHOLOGY DEPARTMENT BROCKTON, MA 02302 (508) 941-7414 |
| 1700813326 | WENDY W TONG M.D. Individual | Internal Medicine | 680 CENTRE ST BROCKTON, MA 02302 (508) 941-7299 |
| 1154350825 | HENRY J GRAZIOSO M.D. Individual | Emergency Medicine | 680 CENTRE ST BROCKTON, MA 02302 (508) 941-7400 |
| 1699705129 | IORAM GRINBLATAS M.D. Individual | Emergency Medicine | 680 CENTRE ST BROCKTON, MA 02302 (508) 941-7400 |
| 1013947688 | DEMIN MA M.D. Individual | Psychiatry & Neurology (Psychiatry) | 680 CENTRE ST BROCKTON, MA 02302 (508) 941-7228 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1174560304, enumerated in the NPI registry as an "organization" on May 31, 2006
The provider is located at 680 Centre St Brockton, Ma 02302 and the phone number is (508) 941-7062
This medical organization specializes in Internal Medicine with taxonomy code 207R00000X
The provider might be accepting Accepts: Medicare, Medicaid and Blue Cross Blue Shield. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
This NPI record was last updated on May 31, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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