42 NORTH DENTAL CARE, LLC — NPI 1063781722 (Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center in SOMERVILLE, MA)

CMS-1500 Box 24J / 33a • NPI

1063781722

Type 2 Organization (Box 32a/33a)

HIPAA NUCC Taxonomy • CMS Code

261QD0000X

Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center

Box 32 Service Location & ZIP+4

14 MCGRATH HWY, SOMERVILLE, MA, 02143-4505

✓ 9-Digit EDI 837 ZIP+4 (02143-4505)

Practice Phone & Referral Fax

(617) 623-4500

Direct NPPES Verification Line

✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR: NPI 1063781722 (42 NORTH DENTAL CARE, LLC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).

CMS Medicare Order & Referring PECOS Eligibility

Institutional Type-2 NPI facilities enroll via CMS-855A institutional provider agreements rather than individual Order & Referring PECOS.

Official CMS NPPES Credential & Practice Profile

10-Digit NPI Number	`1063781722` (NPI-2 Organization / Facility)
Provider / Legal Name	42 NORTH DENTAL CARE, LLC
Plain-English Specialty	Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center NUCC Code: `261QD0000X` (Clinic/Center, Dental)
Certifying / Licensing Body	Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Practice Location Address	14 MCGRATH HWY, SOMERVILLE, MA, 02143-4505
Practice Telephone / Fax	Tel: (617) 623-4500
Administrative Mailing Address	200 5TH AVE FL 3, WALTHAM, MA, 02451-8759
Enumeration & Last Sync	Enumerated: 2011-12-23 \| CMS Record Updated: 2021-06-21
Authorized Official	MICHAEL SCIALABBA (Chief Clinical Officer)

Clinic Location, Accessibility & Directions

📍 Practice Location & Patient Access

14 MCGRATH HWY, SOMERVILLE, MA, 02143-4505

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Plain-English Taxonomy & CMS Crosswalk (261QD0000X)

What Does Taxonomy Code 261QD0000X Mean?

In the HIPAA National Uniform Claim Committee (NUCC) classification, code 261QD0000X translates to:
"Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center"

CMS-1500 Medicare Specialty Crosswalk: Standard HIPAA X12N 837P / CMS-1500
Certifying / Accrediting Authority: Accreditation Association for Ambulatory Health Care (AAAHC) / CMS
Clinical Scope: Same-day outpatient consultations, urgent walk-in medical care, vaccinations, and day-case diagnostic procedures.

Specialty Clinical Procedures & Therapeutic Classes

Standard Scope of Care (42 NORTH DENTAL CARE, LLC)

Typical CPT / Diagnostic Procedures:

Walk-In Urgent Care Evaluation, Point-of-Care Testing & X-Ray
Same-Day Ambulatory Endoscopy, Cataract & Minor Surgical Procedures

Common Therapeutic Classes:

Outpatient Oral Antimicrobials, Analgesics, Nebulizers & Vaccines

All Registered NUCC Taxonomies & State Licenses

Taxonomy Code & Plain-English Description	State License & Primary Status
`261QD0000X` — Clinic/Center, Dental Plain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center	State: N/A \| License: `Verified` \| Primary: Yes (Primary)

Medical Billing, RCM & Hospital Credentialing Teams:

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42 NORTH DENTAL CARE, LLC (NPI #1063781722)