MEDICARE: THOMAS M COLLINS M.D.

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	208000000X	Pediatrics Physician	49292	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	J03294	OTHER	MA	BLUE CROSS
3	4212780	OTHER	MA	AETNA
4	0379225	OTHER	MA	CIGNA
5	1205931	OTHER	MA	UNITED HEALTHCARE
6	700373	OTHER	MA	TUFTS
7	AA48723	OTHER	MA	HARVARD PILGRIM

General Provider Information

NPI Number	:	1053381285
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THOMAS M COLLINS M.D.

Provider Business Mailing Address
First Line	:	147 MILK ST
Second Line	:	PROVIDER ENROLLMENT - 9TH FLOOR
City	:	BOSTON
State	:	MA
Zip	:	02109-4806
Country	:	US
Telephone Number	:	617-559-8104
Fax Number	:	617-421-3487

Provider Business Practice Location Address
First Line	:	16 LANCASTER COUNTY RD
Second Line	:	CONCORD HILLSIDE MEDICAL ASSOCIATES
City	:	HARVARD
State	:	MA
Zip	:	01451-1114
Country	:	US
Telephone Number	:	978-772-6161
Fax Number	:	978-772-4144

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

Provider Enumeration Date	:	01/23/2006
Last Update Date	:	05/07/2009

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Directions to “ THOMAS M COLLINS M.D.” Practice Location

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