BELMONT CAMBRIDGE HEALTH CARE NPI 1003039041

Medical Genetics (Clinical Genetics (M.D.)) in Belmont, MA

NPI 1003039041 Organization Medical Genetics Clinical Genetics (M.D.) CLIA Number 22D2066462 CLIA Certificate of Waiver

About BELMONT CAMBRIDGE HEALTH CARE

Belmont Cambridge Health Care is a provider established in Belmont, Massachusetts specializing in medical genetics (clinical genetics (m.d.)) . The NPI number of Belmont Cambridge Health Care is 1003039041 and was assigned on April 2007. The practitioner's primary taxonomy code is 207SG0201X with license number 152950 (MA). The provider is registered as an organization and their NPI record was last updated one year ago. Belmont Cambridge Health Care operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Dr. Gopal Krishna Gupta Mbbs, Md (Director)

The CLIA number of Belmont Cambridge Health Care is 22D2066462 registered as a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Belmont Cambridge Health Care to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1003039041

Provider NameBELMONT CAMBRIDGE HEALTH CARE
Provider Location Address24 STONY BROOK RD BELMONT, MA 02478
Provider Mailing Address799 CONCORD AVE CAMBRIDGE, MA 02138
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date04-10-2007
Last Update Date08-22-2020


Primary Taxonomy

Taxonomy Code207SG0201X
ClassificationMedical Genetics
TypeAllopathic & Osteopathic Physicians
SpecializationClinical Genetics (M.D.)
License No.152950
License StateMA
Taxonomy DescriptionA clinical geneticist demonstrates competence in providing comprehensive diagnostic, management and counseling services for genetic disorders.

Business Address

BELMONT CAMBRIDGE HEALTH CARE
24 STONY BROOK RD
BELMONT, MA
ZIP 02478
Phone: (617) 484-0929
Fax: (617) 484-0929

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Mailing Address

BELMONT CAMBRIDGE HEALTH CARE
799 CONCORD AVE
CAMBRIDGE, MA
ZIP 02138
Phone: (617) 491-5111
Fax: (617) 491-5222



Authorized Official

Authorized Official NameDR. GOPAL KRISHNA GUPTA MBBS, MD
Authorized Official TitleDIRECTOR
Authorized Official Phone(617) 491-5111

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1003039041 is:

CLIA Number22D2066462
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate of Waiver

Group Taxonomy


193200000X MULTI-SPECIALTY GROUP - This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Secondary Taxonomies


The secondary taxonomy codes define the provider type, classification, and specialization. For individual NPIs the license data is associated to each taxonomy code.

No. Taxonomy Code Type Classification Specialization License No. State Primary
1208000000XAllopathic & Osteopathic PhysiciansPediatrics152950MAN/A

Taxonomy Description: 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.

22080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine152950MAN/A

Taxonomy Description: a pediatrician who is the principal care provider for sick newborn infants. Clinical expertise is used for direct patient care and for consulting with obstetrical colleagues to plan for the care of mothers who have high-risk pregnancies.

Additional Identifiers


Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State
3203395MEDICAID (05)MA

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.