BOSTON SPORTS & SHOULDER CENTER,LLC (NPI# 1619163052) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619163052 |
| Entity Type | Organization |
| Organization Name | BOSTON SPORTS & SHOULDER CENTER,LLC |
| Other Organization Name | BOSTON SPORTS & SHOULDER CENTER |
| Practice Address |
840 Winter St Waltham MA 02451-1433 |
| Practice Telephone | 7818902133 |
| Practice Fax Number | 7818902177 |
| Mailing Telephone | 7818902133 |
| Mailing Fax Number | 7818902177 |
| Enumeration Date | 2007-09-19 |
| Last Update Date | 2015-03-20 |
| Authorized Official Name | SHANNON MARTIN (OFFICE MANAGER) |
| Authorized Official Telephone | 6172641100 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | BLUE CROSS AND BLUE SHIEL | M19061 | 01 |
| MA | TUFTS | 648556 | 01 |
| MA | 9760920 | 05 |
| Other Name | Type Code |
|---|---|
| Boston Sports & Shoulder Center | Doing Business As Name - Organization |
| Street Address |
840 WINTER ST |
| City | WALTHAM |
| State | MA |
| Zip Code | 02451-1433 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144203506 | Christopher Dolan | Physical Therapist | 840 Winter St, Waltham, MA 02451-1433 | 2005-11-21 |
| 1366055337 | Taryn E. Chrysikos | Physical Therapist | 840 Winter St, Waltham, MA 02451-1433 | 2020-08-28 |
| 1124679352 | Dana Cavedon | Specialist/Technologist | 840 Winter St, Waltham, MA 02451-1433 | 2019-09-29 |
| 1205396074 | Stephen Wright | Physician Assistant | 840 Winter St, Waltham, MA 02451 | 2019-03-20 |
| 1629535729 | Stephanie Costa | Physical Therapy Assistant | 840 Winter St, Waltham, MA 02451-1433 | 2019-02-25 |
| 1053891697 | Christian J. Van Der Schijff | Physical Therapist | 840 Winter St, Waltham, MA 02451-1433 | 2018-08-14 |
| 1295213155 | Steven M. Hirsch | Physical Therapist | 840 Winter St, Attn: Pro Sports Therapy, Waltham, MA 02451-1433 | 2018-08-02 |
| 1750893020 | Arthur Horne | Specialist/Technologist | 840 Winter St, Waltham, MA 02451-1433 | 2017-10-26 |
| 1578080321 | Zachary J Mercier | Physical Therapist | 840 Winter St, Waltham, MA 02451-1433 | 2017-08-23 |
| 1205370723 | Massachusetts Anesthesia Associates, P.C. | Anesthesiology | 840 Winter St, Waltham, MA 02451-1433 | 2016-12-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538719190 | Haeun Yang | Behavior Technician | 303 Wyman Street Suite 354, 344, 345, Waltham, MA 02451 | 2019-09-16 |
| 1982252599 | Sinclair Fashaw-braxton | Behavior Technician | 303 Wyman Street, Suite 354, 344, 345, Waltham, MA 02451 | 2019-08-27 |
| 1245715879 | Annie F Friedman | Social Worker | Extended Stay America, 32 4the Avenue, Waltham, MA 02451 | 2018-09-28 |
| 1760964118 | Elizabeth Boardman Harris | Social Worker | 60 Hickory Drive 4th Floor, Waltham, MA 02451 | 2018-09-02 |
| 1760960959 | Patriot Urgent Care Professionals, PC | General Practice | 1030 Main Street, Unit 2, Waltham, MA 02451 | 2018-07-31 |
| 1962998013 | Leighann Teresa Healy | Behavior Technician | 303 Wyman Suite 300, Waltham, MA 02451 | 2018-07-02 |
| 1194234492 | Bruna Rossi Hoffman | Dentist | 12 Grant Place, Apt 1, Waltham, MA 02451 | 2017-09-29 |
| 1265959159 | Matthew C Page-shelton | Counselor | 2208 Stearns Hill Road, Waltham, MA 02451 | 2017-08-23 |
| 1306380837 | Sherri Lynn Duquette | Behavior Technician | 1430 Main Street, Waltham, MA 02451 | 2016-12-19 |
| 1649628728 | Keren Matveev | Family Medicine | 75 Third Avenue, First Floor, Waltham, MA 02451 | 2016-05-30 |
| Find all providers in zip 02451 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609833953 | Suzanne L Miller | Orthopaedic Surgery | 840 Winter Street, Waltham, MA 02451-1433 | 2006-04-28 |
| 1568671188 | Andrew Jawa | Orthopaedic Surgery | 840 Winter Street, Waltham, MA 02451-1433 | 2007-05-21 |
| 1851493928 | John C Richmond | Orthopaedic Surgery | 840 Winter St, Waltham, MA 02451-1433 | 2006-09-01 |
| 1902828304 | Brian P. Mckeon | Orthopaedic Surgery | 840 Winter Street, Waltham, MA 02451 | 2006-07-24 |
| 1437184165 | Boston Sports & Shoulder Center, LLC | Orthopaedic Surgery | 840 Winter St, Attn: Boston Sports & Shoulder Center, Waltham, MA 02451-1433 | 2006-07-11 |
| 1235197872 | Paul P Weitzel | Orthopaedic Surgery | 840 Winter St, Waltham, MA 02451-1433 | 2006-05-03 |
| 1871556738 | Arnold Douglas Scheller Jr. | Orthopaedic Surgery | 840 Winter St, Waltham, MA 02451-1433 | 2006-04-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982212700 | Boston Prolotherapy & Orthopaedics, Pllc | Orthopaedic Surgery | 92 Montvale Ave Ste 4650, Stoneham, MA 02180-3631 | 2020-07-17 |
| 1609403146 | Thomas John Carroll | Orthopaedic Surgery | 224 Donald Ave, Somerset, MA 02726-5411 | 2020-03-25 |
| 1013557727 | University Orthopedics, Inc. | Orthopaedic Surgery | 10 Reservoir St, Mansfield, MA 02048-3104 | 2020-01-10 |
| 1659911618 | Orthopedic Care Physician Network, LLC | Orthopaedic Surgery | 1 Compass Way Ste 202, East Bridgewater, MA 02333-1466 | 2020-01-08 |
| 1457999351 | Orthopedic Care Physician Network LLC | Orthopaedic Surgery | 89 Forbes Blvd Ste 1000, Mansfield, MA 02048-1281 | 2019-12-11 |
| 1750939583 | Qasim Silman Ajmi | Orthopaedic Surgery | Department of Orthopaedic Surgery Boston Medical Center, 850 Harrison Ave Dowling 2 North, Boston, MA 02118 | 2019-08-26 |
| 1871159848 | Andrew Moon | Orthopaedic Surgery | 45 Stuart St Apt 2117, Boston, MA 02116-4769 | 2019-05-15 |
| 1316411929 | Orthopedic Care Physician Network LLC Plymouth | Orthopaedic Surgery | 225 Water St Ste C105, Plymouth, MA 02360-4062 | 2019-01-16 |
| 1871070144 | Giuseppe Orlando | Orthopaedic Surgery | 850 Harrison Avenue, Dowling 2 North Bme, Boston, MA 02118 | 2018-07-19 |
| 1306339676 | Michael Adam Moverman | Orthopaedic Surgery | 19 Julie Rd, North Easton, MA 02356-2114 | 2018-06-12 |
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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.