Healthcare Provider Details

I. General information

NPI: 1164871109
Provider Name (Legal Business Name): REBECCA COMPTON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2016
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 CONGRESS ST STE 2B
QUINCY MA
02169-0960
US

IV. Provider business mailing address

500 CONGRESS ST STE 2B
QUINCY MA
02169-0960
US

V. Phone/Fax

Practice location:
  • Phone: 617-774-1717
  • Fax:
Mailing address:
  • Phone: 617-774-1717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number036.161144
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number266860
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License Number036.161144
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License Number69256
License Number StateMN
# 5
Primary TaxonomyN
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License Number266860
License Number StateMA
# 6
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number69256
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: