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BROCKTON PEDIATRICS
NPI 1629001904
Clinic/Center - Primary Care in Brockton, MA

Active since July 09, 2006CLIA 22D0080539 · Waiver
65 LIBBY ST, BROCKTON, MA 02302(508) 584-6060 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Brockton Pediatrics NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BROCKTON PEDIATRICS (NPI 1629001904) is a healthcare organization registered as a primary care in Brockton, Massachusetts and active in the NPI registry since July 2006. The organization holds a CLIA Waiver certificate valid through April 25, 2028 and lists Yara Fernandez, Md, as its authorized official.

NPPES Registry Identity

NPI1629001904
Entity TypeOrganization
Primary Taxonomy261QP2300X
Legal Business NameBROCKTON PEDIATRICS
Location Address65 LIBBY STBrockton, MA 02302-2949
Mailing Address87 Highland StStoughton, MA 02072-3873
Phone(508) 584-6060
Organization SubpartNo
Authorized OfficialYara FernandezMd · (508) 584-6060
Enumeration DateJuly 9, 2006
Last NPPES UpdateAugust 22, 2020
✔ NPI 1629001904 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Primary CareAmbulatory Health Care Facilities
Taxonomy Code261QP2300X
License✔ Licensed in MA · 150780
65 LIBBY ST, Brockton, MA 02302
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 22D0080539

Brockton Pediatrics Inc · Brockton, MA
Active · expires Apr 25, 2028
CLIA Number22D0080539
Laboratory TypePhysician Office
Certificate Effective DateApril 26, 2026
Certificate Expiration DateApril 25, 2028
Laboratory DirectorHoward H. Kay
Laboratory Phone(508) 584-6060
Laboratory LocationBrockton Pediatrics Inc65 Libby Street, Brockton, MA 02302
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 10

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. HOWARD H KAY MD
Pediatrics
65 LIBBY ST
BROCKTON, MA 02302
Plymouth County (508) 584-6060
MRS. PATRICIA BOUCHER N.P.
Pediatrics (Adolescent Medicine)
65 LIBBY ST
BROCKTON, MA 02302
Plymouth County (508) 584-6060
DR. BRITT LINNEA PENA MD
Pediatrics
65 LIBBY ST
BROCKTON, MA 02302
Plymouth County (508) 584-6060
DR. YAJIE YU MD
Psychiatry & Neurology (Child & Adolescent Psychiatry)
65 LIBBY ST
BROCKTON, MA 02302
Plymouth County (508) 584-6060
MARILYN GORDON MD
Pediatrics
65 LIBBY ST
BROCKTON, MA 02302
Plymouth County (508) 584-6060
JESSICA GATTO RN, CPNP-PC
Nurse Practitioner (Pediatrics)
65 LIBBY ST
BROCKTON, MA 02302
Plymouth County (508) 584-6060
JEREMY EZRA SLOSBERG M.D.
Pediatrics
65 LIBBY ST
BROCKTON, MA 02302
Plymouth County (508) 584-6060
MARYANNE P LADD RN,CPNP
Nurse Practitioner (Pediatrics)
65 LIBBY ST
BROCKTON, MA 02302
Plymouth County (508) 584-6060

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Brockton Pediatrics's NPI number?

The NPI number for Brockton Pediatrics is 1629001904. It was assigned to this organization in the NPPES registry on July 9, 2006.

Where is Brockton Pediatrics located?

Brockton Pediatrics is located at 65 Libby St, Brockton, MA 02302. The listed phone number is (508) 584-6060.

What is Brockton Pediatrics's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Primary Care, with taxonomy code 261QP2300X.

Does Brockton Pediatrics hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 22D0080539) is associated with this NPI, valid through April 25, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Brockton Pediatrics accept?

Health plans from Anthem Blue Cross and Blue Shield list Brockton Pediatrics as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Brockton Pediatrics was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.