SIGNATURE HEALTHCARE BROCKTON HOSPITAL
NPI 1174560304
Internal Medicine in Brockton, MA

NPI Status: Active since May 31, 2006

Contact Information

680 CENTRE ST
BROCKTON, MA
ZIP 02302
Phone: (508) 941-7062
Fax: (508) 941-6337

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  • Organization
  • Internal Medicine

About SIGNATURE HEALTHCARE BROCKTON HOSPITAL

This page provides the complete NPI Profile along with additional information for Signature Healthcare Brockton Hospital, an internist established in Brockton, Massachusetts operating as a Internal Medicine. The healthcare provider is registered in the NPI registry with number 1174560304 assigned on May 2006. The practitioner's primary taxonomy code is 207R00000X. The provider is registered as an organization and their NPI record was last updated 17 years ago. Signature Healthcare Brockton Hospital operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Signature Healthcare Brockton Hospital. The authorized official of this NPI record is Eugene C. Wallace (Ceo)

NPI
1174560304
Provider Legal Name
BROCKTON HOSPITAL SPECIALTY PHYSICIAN GROUP
Other Organization Name
SIGNATURE HEALTHCARE BROCKTON HOSPITAL
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
680 CENTRE ST BROCKTON, MA 02302
Location Phone
(508) 941-7062
Location Fax
(508) 941-6337
Mailing Address
PO BOX 847493 BOSTON, MA 02284
Mailing Phone
(508) 565-0147
Mailing Fax
(508) 941-6337
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-31-2006
Last Update Date
12-22-2009
Code Navigator

An internist like Signature Healthcare Brockton Hospital is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Internal Medicine

Taxonomy Code
207R00000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Secondary Taxonomies

The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.

No. Taxonomy Code Type Classification /
Specialization
License No. (State)
11041C0700XBehavioral Health & Social Service Providers

Social Worker
Clinical

 
2207LP2900XAllopathic & Osteopathic Physicians

Anesthesiology
Pain Medicine

 
3207P00000XAllopathic & Osteopathic Physicians

Emergency Medicine

 
4207RC0000XAllopathic & Osteopathic Physicians

Internal Medicine
Cardiovascular Disease

 
5207RE0101XAllopathic & Osteopathic Physicians

Internal Medicine
Endocrinology, Diabetes & Metabolism

 
6207RG0100XAllopathic & Osteopathic Physicians

Internal Medicine
Gastroenterology

 
7207RP1001XAllopathic & Osteopathic Physicians

Internal Medicine
Pulmonary Disease

 
8207RR0500XAllopathic & Osteopathic Physicians

Internal Medicine
Rheumatology

 
9207V00000XAllopathic & Osteopathic Physicians

Obstetrics & Gynecology

 
10207X00000XAllopathic & Osteopathic Physicians

Orthopaedic Surgery

 
11208000000XAllopathic & Osteopathic Physicians

Pediatrics

 
122084P0800XAllopathic & Osteopathic Physicians

Psychiatry & Neurology
Psychiatry

 
13208600000XAllopathic & Osteopathic Physicians

Surgery

 
14208M00000XAllopathic & Osteopathic Physicians

Hospitalist

 

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.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

EUGENE C. WALLACE

Authorized Official Title
CEO
Authorized Official Phone
(508) 941-7062

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
9757350MEDICAID (05)MA 
M19115OTHER (01)MABCBS GROUP #
M21752MEDICARE ID-TYPE UNSPECIFIED (04)MAGROUP #

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1174560304, we treat the final digit (4) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 46. The final step is to find the difference between that total and the next multiple of ten (50 - 46 = 4).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
1
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
4
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
6
Unchanged
Pos 7
0
Doubled → 0
Pos 8
3
Unchanged
Pos 9
0
Doubled → 0
Check
4
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 7 → 14 → 5 5 → 10 → 1 0 → 0 0 → 0

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 1 + 1 + 4 + 4 + 1 + 0 + 6 + 0 + 3 + 0 + 24 = 46

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 46 is 50. The difference is the calculated check digit.

50 - 46 = 4
This NPI is valid
The calculated check digit is 4, which matches the last digit of 1174560304.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Anesthesiology
680 CENTRE ST
BROCKTON, MA 02302
Anesthesiology
680 CENTRE ST
BROCKTON, MA 02302
Physical Therapist
680 CENTRE ST
BROCKTON, MA 02302
Specialist
680 CENTRE ST
BROCKTON, MA 02302
Internal Medicine (Interventional Cardiology)
680 CENTRE ST
BROCKTON, MA 02302
Anesthesiology
680 CENTRE ST, ANESTHETICS OF BROCKTON, PC
BROCKTON, MA 02302
Obstetrics & Gynecology
680 CENTRE ST
BROCKTON, MA 02302
Emergency Medicine
680 CENTRE ST
BROCKTON, MA 02302
Pathology (Anatomic Pathology & Clinical Pathology)
680 CENTRE ST, PATHOLOGY DEPARTMENT
BROCKTON, MA 02302
Pathology (Anatomic Pathology & Clinical Pathology)
680 CENTRE ST, PATHOLOGY DEPARTMENT
BROCKTON, MA 02302
Pathology (Anatomic Pathology & Clinical Pathology)
680 CENTRE ST, PATHOLOGY DEPARTMENT
BROCKTON, MA 02302
Psychiatry & Neurology (Psychiatry)
680 CENTRE ST
BROCKTON, MA 02302
Anesthesiology
680 CENTRE ST
BROCKTON, MA 02302
Psychiatry & Neurology (Psychiatry)
680 CENTRE ST
BROCKTON, MA 02302
Internal Medicine
680 CENTRE ST
BROCKTON, MA 02302
Pathology (Anatomic Pathology & Clinical Pathology)
680 CENTRE ST, PATHOLOGY DEPARTMENT
BROCKTON, MA 02302
Internal Medicine
680 CENTRE ST
BROCKTON, MA 02302
Emergency Medicine
680 CENTRE ST
BROCKTON, MA 02302
Emergency Medicine
680 CENTRE ST
BROCKTON, MA 02302
Psychiatry & Neurology (Psychiatry)
680 CENTRE ST
BROCKTON, MA 02302

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1174560304, enumerated as an "organization" on May 31, 2006.

The provider is located at 680 CENTRE ST BROCKTON, MA 02302 and the phone number is (508) 941-7062.

Internal Medicine with taxonomy code 207R00000X.

The provider might be accepting Accepts: Medicare, Medicaid and Blue Cross Blue Shield. Please consult your insurance carrier or call the provider to verify.