BROCKTON CARDIOLOGY ASSOCIATES, PC (NPI# 1790874352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790874352 |
| Entity Type | Organization |
| Organization Name | BROCKTON CARDIOLOGY ASSOCIATES, PC |
| Practice Address |
210 Quincy Ave Brockton MA 02302-2862 |
| Practice Telephone | 5085836262 |
| Practice Fax Number | 5085831783 |
| Mailing Telephone | 5085836262 |
| Mailing Fax Number | 5085831783 |
| Enumeration Date | 2006-10-12 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ANDREW L KRIEGEL (PRESIDENT) |
| Authorized Official Telephone | 5085836262 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | UNITED GROUP # | 25227 | 01 |
| MA | TUFTS GROUP # | 600871 | 01 |
| MA | 9769153 | 05 | |
| MA | BCBS GROUP # | M15659 | 01 |
| MA | AETNA GROUP # | 122415 | 01 |
| Street Address |
210 QUINCY AVE |
| City | BROCKTON |
| State | MA |
| Zip Code | 02302-2862 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205469947 | Jiahua Zhang | Nurse Practitioner | 210 Quincy Ave, Brockton, MA 02302-2862 | 2020-02-21 |
| 1861780090 | Jalal Mukhtar | Internal Medicine | 210 Quincy Ave, Brockton, MA 02302-2862 | 2011-07-21 |
| 1346417151 | Health Heart Sleep Lab of Brockton | Clinic/Center | 210 Quincy Ave, Brockton, MA 02302-2862 | 2008-05-12 |
| 1902952542 | Healthy Heart Sleep Programs Inc | Durable Medical Equipment & Medical Supplies | 210 Quincy Ave, Brockton, MA 02302-2862 | 2007-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427513373 | Miriam Monteiro | Social Worker | 688 Plain Street, Brockton, MA 02302 | 2019-02-05 |
| 1619432523 | Shirley Elefson | Social Worker | 330 Crescent Street, Brockton, MA 02302 | 2019-02-05 |
| 1578055505 | Steigmward Desir | Specialist | 472 E Ashland St, Brockton, MA 02302 | 2018-06-05 |
| 1114417797 | Katherine Douglas Van Schaik | Student in an Organized Health Care Education/Training Program | Brockton Signature Healthcare-bidmc, 680 Centre Street, Brockton, MA 02302 | 2018-05-18 |
| 1700376365 | Emmanuel Carrodeguas | Student in an Organized Health Care Education/Training Program | Brockton Hospital, 680 Centre Street, Brockton, MA 02302 | 2018-05-18 |
| 1700303856 | My Care, LLC | Home Health | 307 Field Street, Brockton, MA 02302 | 2017-08-29 |
| 1982124988 | Shavon Franks | Psychologist | 30 Downey Rd, Brockton, MA 02302 | 2017-06-21 |
| 1831629286 | Kings & Queens Empowered | Religious Nonmedical Health Care Institution | 312 Carl Ave, Brockton, MA 02302 | 2017-06-18 |
| 1487193389 | Roseline Eliezer | Licensed Practical Nurse | 17 Simeon Avenue, Brockton, MA 02302 | 2017-02-13 |
| 1184008989 | Danielle Parker | Student in an Organized Health Care Education/Training Program | 23 Grinnell Rd, Brockton, MA 02302 | 2015-07-13 |
| Find all providers in zip 02302 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972569861 | Clifford J Berger | Internal Medicine | 830 Oak St., Suite 205w, Brockton, MA 02301 | 2006-04-21 |
| 1053586487 | Borzoo Nikpoor | Internal Medicine | 680 Centre St, Brockton, MA 02302-3308 | 2008-04-27 |
| 1932248721 | Syed M Tahir | Internal Medicine | 110 Liberty Street, Brockton, MA 02301 | 2007-02-06 |
| 1942390208 | Gary L Miller | Internal Medicine | 830 Oak St, Suite 205w, Brockton, MA 02301-1168 | 2006-10-14 |
| 1376562447 | Bruce J Kriegel | Internal Medicine | 830 Oak St., Suite 205w, Brockton, MA 02301 | 2006-07-19 |
| 1457376717 | Benoy J Zachariah | Internal Medicine | 830 Oak St, Suite 205w, Brockton, MA 02301 | 2006-07-13 |
| 1417904202 | Barry M Arkin | Internal Medicine | 830 Oak St., Suite 205w, Brockton, MA 02301 | 2006-05-28 |
| 1104884022 | Jean-pierre M. Geagea | Internal Medicine | 680 Centre St, Brockton, MA 02302-3308 | 2006-05-02 |
| 1437148145 | Athanasios P Flessas | Internal Medicine | 830 Oak St, Suite 105 W, Brockton, MA 02301-1168 | 2005-10-14 |
| 1063409233 | Chester Melvin Hedgepeth | Internal Medicine | 1 Pearl St, Suite 1000, Brockton, MA 02301-2864 | 2005-10-04 |
| Find all providers in BROCKTON | ||||
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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.