| South Suburban Gastroenterology, Pc | |
|
1085 Main St South Weymouth MA 02190-1547 | |
| (781) 331-2922 | |
| (781) 335-5702 |
| Full Name | South Suburban Gastroenterology, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1085 Main St, South Weymouth, Massachusetts |
| Authorized Official Name and Position | Mary Phillips (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 7813312922 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Suburban Gastroenterology, Pc 1085 Main St South Weymouth MA 02190-1547 Ph: (781) 331-2922 | South Suburban Gastroenterology, Pc 1085 Main St South Weymouth MA 02190-1547 Ph: (781) 331-2922 |
| NPI Number | 1114948478 |
|---|---|
| Provider Enumeration Date | 07/22/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 9931194412 |
|---|---|
| Medicare Enrollment ID | O20040415000288 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114948478 | NPI | - | NPPES |
| 9768882 | Medicaid | MA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Richard S Bello |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1285624312 PECOS PAC ID: 5294632964 Enrollment ID: I20031219000020 |
| Provider Name | Clifford M Breslow |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1639169758 PECOS PAC ID: 0648177311 Enrollment ID: I20031219000034 |
| Provider Name | George A Garcia |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1700823820 PECOS PAC ID: 2365340932 Enrollment ID: I20031222000293 |
| Provider Name | Alison W Gustafson |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1619991650 PECOS PAC ID: 9931007325 Enrollment ID: I20031223000060 |
| Provider Name | Gordon Juric |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1346261302 PECOS PAC ID: 8224936638 Enrollment ID: I20031223000167 |
| Provider Name | Vincent A Mangili |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1467466490 PECOS PAC ID: 5496653685 Enrollment ID: I20031226000021 |
| Provider Name | Elamana Vijayakumar |
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) |
| Provider Identifiers | NPI Number: 1669491890 PECOS PAC ID: 7517865686 Enrollment ID: I20031229000104 |
| Provider Name | David G Wong |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1528032844 PECOS PAC ID: 8325946403 Enrollment ID: I20031229000181 |
| Provider Name | Pamela K Hurst |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1508961285 PECOS PAC ID: 2668371196 Enrollment ID: I20040105000340 |
| Provider Name | Kwai Lan L Lai |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1174601355 PECOS PAC ID: 9032018577 Enrollment ID: I20040105000402 |
| Provider Name | Kevin M Kelley |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1295813558 PECOS PAC ID: 9739088105 Enrollment ID: I20040105000573 |
| Provider Name | Lana L Yaney |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1891753885 PECOS PAC ID: 0143129379 Enrollment ID: I20040107000079 |
| Provider Name | Mary Lou Duthie |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1750468997 PECOS PAC ID: 3678472891 Enrollment ID: I20040107000565 |
| Provider Name | Shilpa B Shah |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1801955398 PECOS PAC ID: 0547246571 Enrollment ID: I20040629000588 |
| Provider Name | Christopher M Kenney |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1497780548 PECOS PAC ID: 8426037771 Enrollment ID: I20040719001358 |
| Provider Name | Thomas J Kenney |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1851328959 PECOS PAC ID: 7810976016 Enrollment ID: I20040720000113 |
| Provider Name | Mekhala Stephen |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1023072287 PECOS PAC ID: 5799755674 Enrollment ID: I20040728000904 |
| Provider Name | Andrew Gutowski |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1396846911 PECOS PAC ID: 4385619568 Enrollment ID: I20041008000937 |
| Provider Name | Kevin M Donovan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1326121641 PECOS PAC ID: 7214997188 Enrollment ID: I20041014000886 |
| Provider Name | Eileen M Marr |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1376518555 PECOS PAC ID: 9032160163 Enrollment ID: I20050207000573 |
| Provider Name | Gilbert A Fishbein |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1528058666 PECOS PAC ID: 8426022872 Enrollment ID: I20050330000947 |
| Provider Name | Michael J Obrien |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1700858438 PECOS PAC ID: 6002705852 Enrollment ID: I20050407000271 |
| Provider Name | Juliet M Liposky |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1265586820 PECOS PAC ID: 8921048984 Enrollment ID: I20050509001014 |
| Provider Name | Wendy L Gross |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1437130358 PECOS PAC ID: 9032141700 Enrollment ID: I20050901000634 |
| Provider Name | Kristen C Stadtlander |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1497700538 PECOS PAC ID: 6901831973 Enrollment ID: I20050928000764 |
| Provider Name | Robert Striglio |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1609819093 PECOS PAC ID: 6305858002 Enrollment ID: I20060621000092 |
| Provider Name | Steve Alves |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1629084546 PECOS PAC ID: 1355231309 Enrollment ID: I20070115000184 |
| Provider Name | Bradford C Sampson |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1962410548 PECOS PAC ID: 7911099221 Enrollment ID: I20070816000273 |
| Provider Name | Traci Ann Brown |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1518022805 PECOS PAC ID: 3779679246 Enrollment ID: I20071013000028 |
| Provider Name | Ellen M Davey |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1023083516 PECOS PAC ID: 8628158516 Enrollment ID: I20080104000252 |
| Provider Name | Marilyn P Nalbach |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1548443658 PECOS PAC ID: 4981782968 Enrollment ID: I20080416000062 |
| Provider Name | Stacey L. Galvin |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1902089014 PECOS PAC ID: 6507945169 Enrollment ID: I20080507000378 |
| Provider Name | Alexander Crissman Boal |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1932347812 PECOS PAC ID: 3870659626 Enrollment ID: I20090304000164 |
| Provider Name | Timothy F Ayers |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1245384775 PECOS PAC ID: 6204993512 Enrollment ID: I20090331000325 |
| Provider Name | John J O'connor |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1295988921 PECOS PAC ID: 3779637780 Enrollment ID: I20090810000601 |
| Provider Name | Elizabeth Mcginnis |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1356450316 PECOS PAC ID: 0042301905 Enrollment ID: I20090827000021 |
| Provider Name | Brian Gill |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1639336423 PECOS PAC ID: 9234284951 Enrollment ID: I20090902000190 |
| Provider Name | Megan H Burns |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1134453095 PECOS PAC ID: 9537295696 Enrollment ID: I20100505000849 |
| Provider Name | Dongdong Yao |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1801088174 PECOS PAC ID: 2466586342 Enrollment ID: I20100813000467 |
| Provider Name | Sandra Cerda |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1306819719 PECOS PAC ID: 3577687870 Enrollment ID: I20100824000020 |
| Provider Name | Jessica Lynn Morrissey |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1639494503 PECOS PAC ID: 0345365383 Enrollment ID: I20100915000254 |
| Provider Name | Jason M. Erlich |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1578709267 PECOS PAC ID: 1850584020 Enrollment ID: I20101020000477 |
| Provider Name | Gregory M Bolduc |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1821078767 PECOS PAC ID: 5890975759 Enrollment ID: I20110209000686 |
| Provider Name | Neyaz Ahmad |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1427213834 PECOS PAC ID: 1254391048 Enrollment ID: I20110322000040 |
| Provider Name | Suzanne M Maynard |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1386641355 PECOS PAC ID: 2961419494 Enrollment ID: I20110505000305 |
| Provider Name | Mark E Wechsler |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1245407378 PECOS PAC ID: 0244487296 Enrollment ID: I20120827000031 |
| Provider Name | Elizabeth Demartini |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1154574036 PECOS PAC ID: 9537226386 Enrollment ID: I20120906000405 |
| Provider Name | Andrew F Burns |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1962766261 PECOS PAC ID: 4981852498 Enrollment ID: I20120906000864 |
| Provider Name | Qing Zhao |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1942404546 PECOS PAC ID: 8123276235 Enrollment ID: I20120914000426 |
| Provider Name | Jonathan P Nass |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1558587998 PECOS PAC ID: 6800065939 Enrollment ID: I20121003000303 |
| Provider Name | Mona Akbari |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1871720037 PECOS PAC ID: 6800045667 Enrollment ID: I20121011000370 |
| Provider Name | Megan R Rice |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1376808501 PECOS PAC ID: 8921258518 Enrollment ID: I20121016000669 |
| Provider Name | Landree E Parrott |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1669813655 PECOS PAC ID: 4183867567 Enrollment ID: I20130904000552 |
| Provider Name | Whitney L Davis |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1518384908 PECOS PAC ID: 9739302290 Enrollment ID: I20140602001249 |
| Provider Name | Ary Lex Auguste |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1508107806 PECOS PAC ID: 5799926929 Enrollment ID: I20140617000509 |
| Provider Name | Fernando Jorge Martinez |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1255598165 PECOS PAC ID: 4981890340 Enrollment ID: I20140618001928 |
| Provider Name | Michael D Bender |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1386056646 PECOS PAC ID: 8729203187 Enrollment ID: I20140627001654 |
| Provider Name | Jonathan B Clark |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1275923781 PECOS PAC ID: 3476879313 Enrollment ID: I20150311001845 |
| Provider Name | Donna M Chapman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063711414 PECOS PAC ID: 1951616580 Enrollment ID: I20150812006265 |
| Provider Name | Sveta Shah Oza |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1073740940 PECOS PAC ID: 0648586644 Enrollment ID: I20150908000992 |
| Provider Name | Carolyn D Tose |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1972984342 PECOS PAC ID: 5991012882 Enrollment ID: I20150909001384 |
| Provider Name | Michelle Monahan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255700167 PECOS PAC ID: 3476859455 Enrollment ID: I20160317001180 |
| Provider Name | Christina C Fulton |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1265822464 PECOS PAC ID: 0648568303 Enrollment ID: I20161012000962 |
| Provider Name | Justin E Damaso |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1679096499 PECOS PAC ID: 9436422383 Enrollment ID: I20170829002023 |
| Provider Name | Lizabeth Jane Noyes |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1740707330 PECOS PAC ID: 7012276769 Enrollment ID: I20180125002202 |
| Provider Name | Krysten Marie Todd |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1467965970 PECOS PAC ID: 6305106048 Enrollment ID: I20180129000778 |
| Provider Name | Robert Berman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1821505280 PECOS PAC ID: 2264795137 Enrollment ID: I20180407000051 |
| Provider Name | Letitia Mazzaferro |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1427406222 PECOS PAC ID: 1052661063 Enrollment ID: I20180912000392 |
| Provider Name | Gerald F. Finerty |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1063867802 PECOS PAC ID: 7416207303 Enrollment ID: I20180914000909 |
| Provider Name | Kerry A Vittum |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1235663089 PECOS PAC ID: 9335491885 Enrollment ID: I20181010002396 |
| Provider Name | Megan E. Pollock |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1558868661 PECOS PAC ID: 9638400740 Enrollment ID: I20191003001811 |
| Provider Name | Travis Cory Caldarone |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1740801299 PECOS PAC ID: 8820414261 Enrollment ID: I20200817002433 |
| Provider Name | Jane Smith Greene |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1336107861 PECOS PAC ID: 8527099035 Enrollment ID: I20210324001394 |
| Provider Name | Ganesh Thippeswamy |
|---|---|
| Provider Type | Practitioner - Anesthesiology |
| Provider Identifiers | NPI Number: 1780115295 PECOS PAC ID: 1254736473 Enrollment ID: I20210825002473 |
| Provider Name | Shelby E Blair |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1689262727 PECOS PAC ID: 8527474642 Enrollment ID: I20220816001321 |
| Provider Name | Rachel J Burbine |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013587641 PECOS PAC ID: 4880060466 Enrollment ID: I20221024000659 |
| Provider Name | Katherine Egan |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1497487185 PECOS PAC ID: 9436530896 Enrollment ID: I20240131001587 |
| Provider Name | Alanna Burchman |
|---|---|
| Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
| Provider Identifiers | NPI Number: 1881158350 PECOS PAC ID: 5991035032 Enrollment ID: I20240415003630 |
Harbor Medical Associates, Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 541 Main St, Suite 400, South Weymouth, MA 02190 Phone: 781-952-1240 Fax: 781-952-1257 | |
Turner Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 571 Main St, Second Floor, South Weymouth, MA 02190 Phone: 781-812-2880 Fax: 781-803-6142 | |
South Shore Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 70 Pleasant St, South Weymouth, MA 02190 Phone: 781-331-2000 | |
Paul J. Duggan, M.d. P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 851 Main St, Suite 25, South Weymouth, MA 02190 Phone: 781-331-3100 Fax: 781-331-3101 |