MEDICARE: SOUTH SHORE ANESTHESIA ASSOCIATES, INC.

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	207LC0200X	Critical Care Medicine (Anesthesiology) Physician	MA
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	MA
3	207L00000X	Anesthesiology Physician	MA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	CB4589	OTHER	MA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	702312	OTHER	MA	TUFTS
2	30994	OTHER	MA	FALLON
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	0007865	OTHER	MA	NEIGHBORHOOD HEALTH
6	M11511	OTHER	MA	BLUE SHIELD
7	600099	OTHER	MA	HARVARD PILGRIM

General Provider Information

NPI Number	:	1770530388
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SOUTH SHORE ANESTHESIA ASSOCIATES, INC.

Provider Business Mailing Address
First Line	:	163 LIBBEY PKWY
Second Line	:	SUITE 301
City	:	WEYMOUTH
State	:	MA
Zip	:	02189-3101
Country	:	US
Telephone Number	:	781-337-4224
Fax Number	:	781-335-0429

Provider Business Practice Location Address
First Line	:	163 LIBBEY PKWY
Second Line	:	SUITE 301
City	:	WEYMOUTH
State	:	MA
Zip	:	02189-3101
Country	:	US
Telephone Number	:	781-337-4224
Fax Number	:	781-335-0429

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RICHARD S. BELLO
Credential	:	M.D.
Telephone Number	:	781-337-4224

Provider Enumeration Date	:	05/28/2006
Last Update Date	:	02/24/2020

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