Provider Demographics
NPI:1831219930
Name:SAPERIA ORTHOPAEDICS AND SPORTS MEDICINE, INC.
Entity type:Organization
Organization Name:SAPERIA ORTHOPAEDICS AND SPORTS MEDICINE, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:M
Authorized Official - Last Name:GORDEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-824-1824
Mailing Address - Street 1:72 WASHINGTON ST
Mailing Address - Street 2:SUITE 2600
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-2491
Mailing Address - Country:US
Mailing Address - Phone:508-824-1824
Mailing Address - Fax:508-880-9857
Practice Address - Street 1:72 WASHINGTON ST
Practice Address - Street 2:SUITE 2600
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-2491
Practice Address - Country:US
Practice Address - Phone:508-824-1824
Practice Address - Fax:508-880-9857
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-30
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA71247207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3387304OtherCIGNA
MA0000026466OtherBMC HEALTHNET MEDICAID
MA9771816Medicaid
MATUFTS HEALTH PLANOtherTUFTS HEALTH PLANS
DB2073OtherRAILROAD MEDICARE
MASAM15843OtherBLUE CROSS BLUE SHIELD
MASAM15843OtherBLUE CROSS BLUE SHIELD
5109690001Medicare NSC
MA0000026466OtherBMC HEALTHNET MEDICAID