MEDICARE: BOSTON BRACE INTERNATIONAL INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies
2	335E00000X	Prosthetic/Orthotic Supplier

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	203318	OTHER	BLUE CROSS KHPE
4	006759	OTHER	AETNA HMO
5	60008DM	OTHER	KEYSTONE MERCY
6	4532848	OTHER	AETNA NON HMO

General Provider Information

NPI Number	:	1902864150
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOSTON BRACE INTERNATIONAL INC.

Provider Business Mailing Address
First Line	:	37 SHUMAN AVE
Second Line	:
City	:	STOUGHTON
State	:	MA
Zip	:	02072-3734
Country	:	US
Telephone Number	:	508-588-6060
Fax Number	:	508-559-2750

Provider Business Practice Location Address
First Line	:	3550 MARKET ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19104-3369
Country	:	US
Telephone Number	:	215-634-9399
Fax Number	:	267-787-5624

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	MR. THOMAS H. MORRISSEY
Credential	:
Telephone Number	:	508-588-6060

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	03/03/2025

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