MEDICARE: DR. JOHN THOMAS FRASCA MD

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	2086S0129X	Vascular Surgery Physician	58215	MA
2	208600000X	Surgery Physician	58215	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	17-02018	OTHER	MA	UNITED HEALTH
2	8514	OTHER	MA	HARVARD PILGRIM
3	822787	OTHER	MA	US HEALTHCARE
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	709064	OTHER	MA	TUFTS
6	J06801	OTHER	MA	BLUE CROSS & BLUE SHIELD

General Provider Information

NPI Number	:	1962449959
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN THOMAS FRASCA MD

Provider Business Mailing Address
First Line	:	31 PINE ST STE 202
Second Line	:
City	:	NORFOLK
State	:	MA
Zip	:	02056-1680
Country	:	US
Telephone Number	:	508-660-1115
Fax Number	:	508-660-1114

Provider Business Practice Location Address
First Line	:	31 PINE ST
Second Line	:	SUITE 202
City	:	NORFOLK
State	:	MA
Zip	:	02056-1642
Country	:	US
Telephone Number	:	508-660-1115
Fax Number	:	508-660-1114

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2006
Last Update Date	:	10/27/2020

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Directions to “ DR. JOHN THOMAS FRASCA MD” Practice Location

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