Provider Demographics
NPI:1306908561
Name:KAPASI ASSOCIATES P.C.
Entity type:Organization
Organization Name:KAPASI ASSOCIATES P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ONALY
Authorized Official - Middle Name:A
Authorized Official - Last Name:KAPASI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:781-326-0077
Mailing Address - Street 1:80 BRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-1765
Mailing Address - Country:US
Mailing Address - Phone:781-326-0077
Mailing Address - Fax:781-326-4300
Practice Address - Street 1:80 BRIDGE ST
Practice Address - Street 2:
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-1765
Practice Address - Country:US
Practice Address - Phone:781-326-0077
Practice Address - Fax:781-326-4300
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KAPASI ASSOCIATES P. C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-12-14
Last Update Date:2008-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA39392208VP0000X, 207Q00000X, 207QS0010X, 207VG0400X
MA040613207X00000X, 207XX0005X
MA40613208VP0000X
MA77242207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports MedicineGroup - Multi-Specialty
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0004568OtherMEDICARE PTAN
MA9771956Medicaid
MAKAM13306OtherBLUE CROSS BLUE SHEILD
MA000456801OtherMEDICARE PTAN
MAKAM13306OtherBLUE CROSS BLUE SHEILD
MA0004568OtherMEDICARE PTAN