CENTRAL MASS PEDIATRIC GI & NUTRITION, P.C. (NPI# 1114195179) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114195179 |
| Entity Type | Organization |
| Organization Name | CENTRAL MASS PEDIATRIC GI & NUTRITION, P.C. |
| Practice Address |
123 Summer Street Suite 630 Worcester MA 01608 |
| Mailing Address |
Po Box 1025 Worcester MA 01613-1025 |
| Practice Telephone | 5083637344 |
| Mailing Telephone | 5083637344 |
| Enumeration Date | 2008-02-13 |
| Last Update Date | 2008-02-13 |
| Authorized Official Name | IDRIS DAHOD (PRESIDENT) |
| Authorized Official Telephone | 5083637344 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0206X |
Pediatrics Specialization: Pediatric Gastroenterology |
156574 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 3185796 | 05 | |
| MA | FALLON | 55515 | 01 |
| MA | BLUE CROSS BLUE SHIELD | M18069 | 01 |
| MA | TUFTS | 691538 | 01 |
| Street Address |
123 SUMMER STREET SUITE 630 |
| City | WORCESTER |
| State | MA |
| Zip Code | 01608 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730181876 | George Abraham | Internal Medicine | 123 Summer Street, Suite 370 North, Worcester, MA 01608-1312 | 2005-06-01 |
| 1467004366 | Shwetha Rupendu | Internal Medicine | 123 Summer Street, Worcester, MA 01608-0160 | 2019-07-10 |
| 1811479520 | Danielle Maria Mastalerz | Dietitian, Registered | 123 Summer Street, Food and Nutrition, Suite 125, Worcester, MA 01608 | 2018-08-30 |
| 1245716034 | Shubhi Pandey | Internal Medicine | 123 Summer Street, Department of Medicine, Suite 120 South, Worcester, MA 01608 | 2018-07-14 |
| 1891210829 | Fnu Ashna Rajan | Internal Medicine | 123 Summer Street, Suite 120, Worcester, MA 01608 | 2017-08-10 |
| 1568810273 | Sai Katta | General Acute Care Hospital | 123 Summer Street, Saint Vincent Hospital, Worcester, MA 01608 | 2016-06-03 |
| 1295087914 | Parul Nagar | Obstetrics & Gynecology | 123 Summer Street, 587, Worcester, MA 01608 | 2012-10-04 |
| 1265729602 | Fouad Iba F Al Adel | Internal Medicine | 123 Summer Street, Worcester, MA 01608-1216 | 2011-07-06 |
| 1659668101 | Basim A Baragaba | Internal Medicine | 123 Summer Street, Worcester, MA 01608 | 2011-07-06 |
| 1811228273 | Christopher A Strassberger | Physician Assistant | 123 Summer Street, Worcester, MA 01608-1216 | 2010-01-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033721733 | Rebecca Smith Morgan | Physical Therapist | Easter Seals Massachusetts, 484 Main St, Worcester, MA 01608 | 2020-08-24 |
| 1083244057 | Marc Labb | Counselor | 25 Union St 3rd Floor, Worcester, MA 01608 | 2020-01-18 |
| 1154974145 | Shanil Shah | Student in an Organized Health Care Education/Training Program | St Vincent Hospital, Department of Internal Medicine, 123 Summer Street, Worcester, MA 01608 | 2019-07-19 |
| 1194377069 | Varun Kommalapati | Student in an Organized Health Care Education/Training Program | St Vincent Hospital, 123 Summer Street, Worcester, MA 01608 | 2019-07-11 |
| 1992361182 | Jenna Recko | Physical Therapy Assistant | Easter Seals of Massachusetts, 484 Main St, Worcester, MA 01608 | 2019-05-14 |
| 1619452646 | Kara Thompson | Registered Nurse | 100 Martin Luther King Jr Blvd, Worcester, MA 01608 | 2018-09-25 |
| 1427555325 | Baran Umut Vardar | Student in an Organized Health Care Education/Training Program | 123 Summer Street, Saint Vincent Hospital Radiology Dep, Worcester, MA 01608 | 2018-04-09 |
| 1609380765 | Mary Elizabeth O'donnell | Occupational Therapist | Easter Seals Ma, 484 Main Street, Worcester, MA 01608 | 2017-11-28 |
| 1093227316 | Oasis Home Care, LLC | Home Health | 340 Main St Ste 803, Worcester, MA 01608 | 2017-10-26 |
| 1912437500 | Peter A Rondon | Social Worker | 11 Sycamore Street, Worcester, MA 01608 | 2017-06-15 |
| Find all providers in zip 01608 | ||||
| Taxonomy Code | 2080P0206X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Gastroenterology |
| A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801977640 | Jay G. Fong | Pediatrics | 55 Lake Ave North, Worcester, MA 01655 | 2006-10-18 |
| 1265485767 | Idris Z Dahod | Pediatrics | 123 Summer St, Worcester, MA 01608-1200 | 2006-05-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467691329 | Wael N. Sayej | Pediatrics | 50 Wason Ave Fl 1, Springfield, MA 01107-1280 | 2009-02-16 |
| 1063674414 | Alexandra N Carey | Pediatrics | 333 Longwood Ave Fl 4, Division of Pediatric Gastroenterology and Nutrition, Boston, MA 02115-5711 | 2008-06-26 |
| 1437335239 | Khoa Dang Tran | Pediatrics | 800 Washington St, Box# 286, Tufts Medical Center, Department of Pediatrics, Boston, MA 02111-1552 | 2008-01-11 |
| 1881700706 | Uzma Shah | Pediatrics | 175 Cambridge Street, Cpzs-575, Boston, MA 02114-2743 | 2006-08-22 |
| 1700803160 | Elizabeth J Hait | Pediatrics | Childrens Hospital, 300 Longwood Avenue, Boston, MA 02115 | 2006-07-15 |
| 1144209446 | William Alian Walker | Pediatrics | 55 Fruit Street B114 3501, Massachusetts General Hospital, Boston, MA 02114 | 2006-01-13 |
| 1265413009 | Anastasios G Angelides | Pediatrics | 50 Wason Ave, 1st Fl, Springfield, MA 01107-1274 | 2005-11-09 |
| 1891355715 | Kathryn Broyles | Pediatrics | 300 Longwood Ave, Boston, MA 02115-5724 | 2019-06-13 |
| 1477049468 | Abigail Francis Cross | Pediatrics | 300 Longwood Ave, Boston, MA 02115-5724 | 2018-07-03 |
| 1356768816 | Jessica Lacy Yasuda | Pediatrics | 300 Longwood Ave, Boston, MA 02115-5724 | 2014-03-23 |
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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.