COMMONWEALTH PLASTIC SURGERY LLC (NPI# 1568854008) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568854008 |
| Entity Type | Organization |
| Organization Name | COMMONWEALTH PLASTIC SURGERY LLC |
| Practice Address |
500 Congress St Suite B1 Quincy MA 02169-0908 |
| Practice Telephone | 6174726764 |
| Practice Fax Number | 6177709933 |
| Mailing Telephone | 6174726764 |
| Mailing Fax Number | 6177709933 |
| Enumeration Date | 2015-02-20 |
| Last Update Date | 2015-06-24 |
| Authorized Official Name | DR. GENEVIEVE B BRODERICK (OWNER) |
| Authorized Official Telephone | 6174726764 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
233883 | MA | Allopathic & Osteopathic Physicians |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Massachusetts Corporations | COMMONWEALTH PLASTIC SURGERY LLC | 21 Mayor Thomas J. Mcgrath Hwy., Ste. 202, Quincy, MA 02169 |
| Street Address |
500 CONGRESS ST SUITE B1 |
| City | QUINCY |
| State | MA |
| Zip Code | 02169-0908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942200324 | Jeanne C Benoit | Nurse Practitioner | 500 Congress St, Quincy, MA 02169-0908 | 2005-07-28 |
| 1407362577 | Donna M Osis | Hearing Instrument Specialist | 500 Congress St, Quincy, MA 02169-0908 | 2017-12-27 |
| 1497106389 | Valeria Duque | Audiologist | 500 Congress St, Suite 2j, Quincy, MA 02169-0908 | 2016-06-22 |
| 1518337062 | Atrius Health, Inc. | Nutritionist | 500 Congress St, Suite 3c, Quincy, MA 02169-0908 | 2015-09-28 |
| 1427428978 | Atrius Health, Inc. | Nutritionist | 500 Congress St, Suite 3c, Quincy, MA 02169-0908 | 2015-09-28 |
| 1477937480 | Dermasap Pllc | Dermatology | 500 Congress St, B1, Quincy, MA 02169-0908 | 2015-07-20 |
| 1558756759 | Atrius Health, Inc. | Dermatology | 500 Congress St, Suite 3c, Quincy, MA 02169-0908 | 2015-04-03 |
| 1760804603 | Maria Mamakos | Nurse Practitioner | 500 Congress St, Quincy, MA 02169-0908 | 2014-01-13 |
| 1730527474 | Antoin Johnsen Deschrijver | Student in an Organized Health Care Education/Training Program | 500 Congress St, Suite 2h, Quincy, MA 02169 | 2013-06-04 |
| 1033470117 | Barbara Nankin | Dentist | 500 Congress St, Suite 2d, Quincy, MA 02169-0908 | 2012-06-05 |
| Find all providers in the same location | ||||
| 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 | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114084191 | Genevieve B Broderick | Surgery | 500 Congress St, Suite B1, Quincy, MA 02169-0908 | 2007-01-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538701776 | Nepsc-lowell LLC | Surgery | 33 Village Square, Chelmsford, MA 01824 | 2019-10-09 |
| 1336792498 | Dexterity Hand Surgery, LLC | Surgery | 100 Unicorn Park Dr Ste 102, Woburn, MA 01801-3379 | 2019-07-18 |
| 1528280203 | Plastic Surgery Specialists | Surgery | 332 Washington St., Wellesley, MA 02481 | 2007-05-03 |
| 1568584852 | Jeffrey H Lee | Surgery | 170 Commonwealth Avenue, St 112, Boston, MA 02116 | 2007-04-06 |
| 1750423711 | Curtis Ngau | Surgery | 231 Worcester Rd, Framingham, MA 01701-5346 | 2007-02-13 |
| 1821195439 | Richard A Peinert | Surgery | Post Office Square, Lynnfield Medical Build, Lynnfield, MA 01940 | 2006-09-19 |
| 1710095559 | Katherine D Hein Md PC | Surgery | 117 West Central Street, Suite 203, Natick, MA 01760 | 2006-08-29 |
| 1598780363 | Katherine D Hein | Surgery | 117 W Central Street, Suite 203, Natick, MA 01760-4383 | 2006-07-13 |
| 1831138825 | Kenneth A Marshall | Surgery | 204 Worcester St, Wellesley Hills, MA 02481-5420 | 2006-06-05 |
| 1932148939 | Sumner A Slavin | Surgery | 200 Boylston St Ste 307, Chestnut Hill, MA 02467-2008 | 2006-06-05 |
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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.