Provider Demographics
| NPI: | 1124079561 |
|---|---|
| Name: | HARBOR MEDICAL ASSOCIATES, INC. |
| Entity type: | Organization |
| Organization Name: | HARBOR MEDICAL ASSOCIATES, INC. |
| Other - Org Name: | |
| Other - Org Type: | |
| Authorized Official - Title/Position: | CHIEF |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | SARATHCHANDRA |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | REDDY |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 781-848-6040 |
| Mailing Address - Street 1: | 541 MAIN ST |
| Mailing Address - Street 2: | SUITE 400 |
| Mailing Address - City: | SOUTH WEYMOUTH |
| Mailing Address - State: | MA |
| Mailing Address - Zip Code: | 02190-1868 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 781-952-1240 |
| Mailing Address - Fax: | 781-952-1257 |
| Practice Address - Street 1: | 541 MAIN ST |
| Practice Address - Street 2: | SUITE 400 |
| Practice Address - City: | SOUTH WEYMOUTH |
| Practice Address - State: | MA |
| Practice Address - Zip Code: | 02190-1868 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 781-952-1240 |
| Practice Address - Fax: | 781-952-1257 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2006-05-12 |
| Last Update Date: | 2025-02-14 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| 207Q00000X, 207R00000X, 207RC0001X, 207RE0101X, 207RG0100X, 207RH0003X, 207RI0011X, 207RP1001X, 207RS0012X, 207RC0000X | ||
| MA | 207UN0901X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
| No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 207RC0001X | Allopathic & Osteopathic Physicians | Internal Medicine | Clinical Cardiac Electrophysiology | Group - Multi-Specialty |
| No | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | Group - Multi-Specialty |
| No | 207RG0100X | Allopathic & Osteopathic Physicians | Internal Medicine | Gastroenterology | Group - Multi-Specialty |
| No | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | Group - Multi-Specialty |
| No | 207RI0011X | Allopathic & Osteopathic Physicians | Internal Medicine | Interventional Cardiology | Group - Multi-Specialty |
| No | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | Group - Multi-Specialty |
| No | 207RS0012X | Allopathic & Osteopathic Physicians | Internal Medicine | Sleep Medicine | Group - Multi-Specialty |
| No | 207UN0901X | Allopathic & Osteopathic Physicians | Nuclear Medicine | Nuclear Cardiology | Group - Multi-Specialty |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| MA | 0009288 | Other | NEIGHBORHOOD HEALTH PLAN |
| MA | 603236 | Other | TUFTS GROUP NUMBER |
| MA | 9741194 | Medicaid | |
| MA | M13981 | Other | BLUE CROSS BLUE SHIELD |
| MA | 084 | Other | TUFTS MEDICARE PREFERRED |
| MA | 24323 | Other | FALLON COMM HEALTH PLAN |
| MA | 603236 | Other | TUFTS GROUP NUMBER |