MYSTIC VALLEY PEDIATRICS – NPI #1043293731
Pediatrics

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Health Care Provider Taxonomy Code for Pediatrics

MYSTIC VALLEY PEDIATRICS is a provider located in MEDFORD, MA. NPPES has assigned the NPI number 1043293731 to MYSTIC VALLEY PEDIATRICS on November 28, 2005. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “MYSTIC VALLEY PEDIATRICS” is a dba name, the actual legal business name for this organization is WINCHESTER PHYSICIAN ASSOCIATES. The primary taxonomy selected by this provider is 208000000X from the Health Care Provider Taxonomy code set, which is classified as Pediatrics.

The NPI profile was previously updated about 18 years ago on Mar 20, 2008. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for MYSTIC VALLEY PEDIATRICS below.

NPI Profile for
WINCHESTER PHYSICIAN ASSOCIATES

NPI Number
1043293731
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
WINCHESTER PHYSICIAN ASSOCIATES
Doing Business As (dba): MYSTIC VALLEY PEDIATRICS
Primary location
75 RIVERSIDE AVE
2
MEDFORD, MA 02155-4600
Phone: (781) 391-8821 Fax: (781) 395-8798
Mailing address
PO BOX 760
WINCHESTER, MA 01890-4260
Phone: (781) 756-7273 Fax: (781) 756-7274
Organization Subpart
No
Authorized Official
EILEEN WILLS
BILLING MANAGER
Phone: (781) 756-7273
Updated
Identifiers

Identifiers for MYSTIC VALLEY PEDIATRICS

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDMA9777229
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
208000000X
- Pediatrics (Primary)		 MA 73721

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.