Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 273Y00000X | Rehabilitation Unit | | VQKK | MASSACHUSETTS | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | HO1478 | OTHER | | OXFORD |
| 2 | 900201 | OTHER | | TUFTS HEALTH PLAN OUTPT |
| 3 | 1099981 | MEDICAID | MASSACHUSETTS | |
| 4 | 991396 | OTHER | | CONNECTICARE |
| 5 | 220046 | OTHER | | HUMANA |
| 6 | 2222004630 | OTHER | MASSACHUSETTS | BLUE CROSS SDC |
| 7 | 260158 | OTHER | | MAGELLAN BEHAVIORAL HEALT |
| 8 | 6300730 | OTHER | | AETNA |
| 9 | 22T046 | MEDICARE OSCAR/CERTIFICATION | MASSACHUSETTS | |
| 10 | 2222004610 | OTHER | MASSACHUSETTS | BLUE CROSS OUTPT |
| 11 | 900357 | OTHER | | HARVARD PILGRIM HEALTH |
| 12 | 10005746 | OTHER | | CDPHP |
| 13 | 20300 | OTHER | MASSACHUSETTS | BMC HEALTH NET PLAN |
| 14 | MVP | OTHER | | 0160 |
| 15 | 10558 | OTHER | | HEALTH NEW ENGLAND |
| 16 | 220046 | OTHER | MASSACHUSETTS | UNICARE MA EMPLOYEE GIC |
| 17 | 2222004601 | OTHER | MASSACHUSETTS | BLUE CROSS INPT |
| 18 | 905652 | OTHER | | TUFTS HEALTH PLAN INPT |
| 19 | 1200143 | MEDICAID | MASSACHUSETTS | |