DAVIS SQUARE FAMILY PRACTICE
NPI 1780782409
Family Medicine in Somerville, MA
About Davis Square Family Practice NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DAVIS SQUARE FAMILY PRACTICE (NPI 1780782409) is a healthcare organization registered as a family medicine in Somerville, Massachusetts and active in the NPI registry since September 2006. The organization holds a CLIA Microscopy certificate valid through July 11, 2028 and lists Deborah Bershel, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 5
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Davis Square Family Practice is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
6Medicare enrollment records show 6 clinicians reassign Medicare billing to Davis Square Family Practice, which bills Medicare for the services they deliver. Of these, 4 practice at this address and 6 within 10 miles. They are listed nearest first.
Clinicians, nearest first (6)
Dorchester, MA 02125
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 for Provider-Performed Microscopy Procedures (PPMP) 22D0076428
Davis Square Family Practice PC · Somerville, MAFrequently 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 Davis Square Family Practice's NPI number?
The NPI number for Davis Square Family Practice is 1780782409. It was assigned to this organization in the NPPES registry on September 20, 2006.
Where is Davis Square Family Practice located?
Davis Square Family Practice is located at 260 Elm St Suite 105, Somerville, MA 02144. The listed phone number is (617) 666-9577.
What is Davis Square Family Practice's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Davis Square Family Practice enrolled in Medicare?
Yes. Davis Square Family Practice is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Davis Square Family Practice?
According to the CMS Revalidation Reassignment List (October 2026 release), 6 clinicians in 2 Medicare specialties reassign their Medicare billing to Davis Square Family Practice. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (5) and Family Practice (1). Of these, 4 practice at this address and 6 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Davis Square Family Practice hold a CLIA laboratory certificate?
Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 22D0076428) is associated with this NPI, valid through July 11, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Davis Square Family Practice was last updated on November 10, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 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.
# Davis Square Family Practice · NPI 1780782409
Family Medicine organization in Somerville, Massachusetts. Organization record, active in the CMS NPPES registry since September 20, 2006.
## Identity
- **NPI:** 1780782409 (Entity type: Organization)
- **Enumerated:** September 20, 2006
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Deborah Bershel, OWNER
## Practice location
- **Address:** 260 ELM ST, SUITE 105, Somerville, MA 02144-2951
- **Phone:** (617) 666-9577 · **Fax:** (617) 666-3190
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 6 clinicians in 2 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (5), Family Practice (1); 4 practice at this address and 6 within 10 miles · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** November 10, 2011
- **Other identifiers:** Other 694934 (MA); Medicaid 9722131 (MA); Medicare PIN M21149 (MA); and 2 more
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1780782409) · Data from the CMS NPPES public registry.