SCOTT GORDON PLACE MD
NPI 1982280632
Student in an Organized Health Care Education/Training Program in Boston, MA

Q: What is the provider's specialty?

The provider's specialty is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Active since March 23, 2021PECOS Enrolled

801 MASSACHUSETTS AVE, STE 5A CROSSTOWN BLDG, BOSTON, MA 02118(617) 414-5951(617) 414-9251 Get Directions Write a Review

NPPES record last updated: April 23, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Apr 23, 2024, Mar 23, 2021 (2 updates tracked since 2021).

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About Scott Gordon Place Md NPPES

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

SCOTT GORDON PLACE MD (NPI 1982280632) is an individual student in an organized health care education/training program in Boston, Massachusetts and active in the NPI registry since March 2021. He is enrolled in Medicare PECOS and maintains a secondary practice location in Boston.

NPPES Registry Identity

NPI1982280632

Entity TypeIndividualMale

Primary Taxonomy390200000X

Provider Legal NameSCOTT GORDON PLACECredential: MD

Location Address801 MASSACHUSETTS AVE, STE 5A CROSSTOWN BLDGBoston, MA 02118-3549

Mailing Address960 Massachusetts Ave, Fl 2Boston, MA 02118

Phone(617) 414-5951

Fax(617) 414-9251

Sole ProprietorNo

Enumeration DateMarch 23, 2021

Last NPPES UpdateApril 23, 20242 updates tracked since enumeration

NPPES CertifiedApril 16, 2024

✔ NPI 1982280632 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Also ListedInternal MedicineTaxonomy 207R00000X · License 1018251 (MA)

801 MASSACHUSETTS AVE, Boston, MA 02118

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Secondary Practice Location 1

Location 172 E Newton St Ste 124Boston, MA 02118-2308 · Phone (617) 638-7253 · Fax (617) 638-6501

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Scott Gordon Place Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.