CROSSOVER HEALTH MEDICAL GROUP (NPI# 1104263953) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104263953 |
| Entity Type | Organization |
| Organization Name | CROSSOVER HEALTH MEDICAL GROUP |
| Practice Address |
35 Dory Rd Gloucester MA 01930-2236 |
| Mailing Address |
26831 Aliso Creek Rd Ste 200 Aliso Viejo CA 92656-5341 |
| Practice Telephone | 9498910328 |
| Mailing Telephone | 9498910328 |
| Enumeration Date | 2013-06-03 |
| Last Update Date | 2013-06-03 |
| Authorized Official Name | RICHARD M PATRAGNONI (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 9498910328 |
| Authorized Official Credential | M.D |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | A62815 | CA | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205443751 | Crossover Health Medical Group | Clinic/Center | 424 E. 4th St, Suite 100, Royal Oak, MI 48067 | 2020-09-29 |
| 1184231037 | Crossover Health Medical Group | Clinic/Center | 434 Patrol Rd, Jeffersonville, IN 47130-7754 | 2020-09-24 |
| 1982211835 | Crossover Health Medical Group | Clinic/Center | 711 W 2nd St Ste A, San Bernardino, CA 92410-3262 | 2020-09-24 |
| 1619584570 | Crossover Health Medical Group | Clinic/Center | 19901 Dix Toledo Hwy, Brownstown Twp, MI 48183-1039 | 2020-09-24 |
| 1982211843 | Crossover Health Medical Group | Clinic/Center | 5379 Hamner Ave Unit 801, Eastvale, CA 91752-1042 | 2020-09-24 |
| 1992312847 | Crossover Health Medical Group | Clinic/Center | 544 Conestoga Pkwy Ste 3, Shepherdsville, KY 40165-5676 | 2020-09-24 |
| 1639786585 | Crossover Health Medical Group | Clinic/Center | 1847 E Southern Ave Ste 3, Tempe, AZ 85282-5881 | 2020-09-24 |
| 1164039020 | Crossover Health Medical Group | Clinic/Center | 14329 Frederick St Ste 7-9, Moreno Valley, CA 92553-9003 | 2020-09-24 |
| 1821605775 | Crossover Health Medical Group | Clinic/Center | 5251 W Campbell Ave Ste 200, Phoenix, AZ 85031-1719 | 2020-09-24 |
| 1649887597 | Crossover Health Medical Group | Clinic/Center | 8343 W Van Buren St Bldg C-2, Tolleson, AZ 85353-3225 | 2020-09-24 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Washington State Corporations | CROSSOVER HEALTH MEDICAL GROUP, APC | 101 W Avenida Vista Hermosa, San Clemente, CA 92672-7706 |
| New York State Corporations | CROSSOVER HEALTH MEDICAL GROUP, APC | 99 Washington Avenue, Suite 1008, Albany, New York 12260 |
| Massachusetts Corporations | CROSSOVER HEALTH MEDICAL GROUP, APC | 65 Enterprise, Alisa Viejo, CA 92656 |
| Colorado Business Entities | CROSSOVER HEALTH MEDICAL GROUP, APC | 101 West Avenida Vista Hermosa, Suite 120, San Clemente, CA 92672 |
| Street Address |
35 DORY RD |
| City | GLOUCESTER |
| State | MA |
| Zip Code | 01930-2236 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316985419 | Barry Giglio | Family Medicine | 35 Dory Rd, Gloucester, MA 01930-2236 | 2006-06-02 |
| 1801131842 | Healthstat On-site Clinic/varian- Gloucester | Preventive Medicine | 35 Dory Rd, Gloucester, MA 01930-2236 | 2012-12-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528538592 | Kimberly Moniz | Counselor | 3 & 4 Blackburn Center, Gloucester, MA 01930 | 2018-12-03 |
| 1770066714 | Anneliese Deckert | Counselor | 3 & 4 Blackburn Center Drive, Gloucester, MA 01930 | 2018-09-14 |
| 1497231070 | Erika Ackermann Duffy | Social Worker | Beeman Elementary School, 138 Cherry Street, Gloucester, MA 01930 | 2018-07-17 |
| 1639677958 | Sarah Bethany Stockwell | Counselor | 3 Blackburn Center Drive, Gloucester, MA 01930 | 2018-02-01 |
| 1164931721 | Samantha Carapellucci | Counselor | Children Friend Familes, 33 Commercial Street, Gloucester, MA 01930 | 2017-09-27 |
| 1215455860 | Jennifer Catherine Hynes | Social Worker | 33 Commercial Street, Gloucester, MA 01930 | 2017-09-05 |
| 1952829590 | Jessica Demarjian | Counselor | 24 Glemere Ave, Gloucester, MA 01930 | 2017-09-04 |
| 1033636600 | Anne Kirk Drueding | Social Worker | 29a Emerson Avenue, Gloucester, MA 01930 | 2017-08-24 |
| 1982128211 | Kristen Elizabeth Drischler | Registered Nurse | 29a Emerson Ave, Gloucester, MA 01930 | 2017-07-28 |
| 1992229207 | Jacqueline Marie Misuraca | Registered Nurse | 29 A Emerson Ave, Gloucester, MA 01930 | 2017-07-28 |
| Find all providers in zip 01930 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033112966 | Judith Monteferrante | Specialist | 45 Eastern Point Rd, Gloucester, MA 01930-4139 | 2005-05-24 |
| 1689956831 | Sports Medicine North Orthopaedic Surgery, Inc | Specialist | 1 Blackburn Dr, Suite 5, Gloucester, MA 01930-2237 | 2011-09-14 |
| 1568674133 | Dermatology Consultants of Gloucester P L L C | Specialist | 6790 Wood Ridge Drive, Gloucester, VA 23061 | 2007-05-04 |
| 1922156439 | J. Barry Claycomb | Specialist | 31 Shore Rd, Gloucester, MA 01930-3916 | 2007-01-08 |
| 1598793382 | Northeast Medical Practice | Specialist | 302 Washington St, Gloucester, MA 01930-4836 | 2006-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689275760 | Heather Audra Wickham | Specialist | 19 Lukes Way, Plymouth, MA 02360-4717 | 2020-11-04 |
| 1811595440 | Elite Upper Extremity and Plastic Surgery, Pllc | Specialist | 123 Summer St Ste 550, Worcester, MA 01608-1216 | 2020-10-15 |
| 1285272559 | Michael Anthony Mandella | Specialist | 615 Reservoir Rd, Lunenburg, MA 01462-1540 | 2019-12-17 |
| 1003372996 | Pic A Nit LLC | Specialist | 111 Worcester Street, North Grafton, MA 01536 | 2019-02-15 |
| 1427513738 | Arlene L Casassa | Specialist | 271 Pond St, Hopkinton, MA 01748-1509 | 2019-01-31 |
| 1851881767 | Cheryl Ann Borden | Specialist | 51 Country Club Way, Ipswich, MA 01938-3000 | 2018-05-16 |
| 1518469089 | Kathleen L Golemon | Specialist | 100 Cummings Center Suite 158-d, Beverly, MA 01915 | 2018-03-01 |
| 1114426988 | Louise Berit Homstead | Specialist | 108 N Main St Ste A, Sunderland, MA 01375-9502 | 2018-02-07 |
| 1356859425 | Tanya Elaine Lachowicz | Specialist | 19 Agassiz St Apt 1, Cambridge, MA 02140-2826 | 2018-01-11 |
| 1083126338 | Kailash Nagrath | Specialist | 33 Sequattom Road, Harwich, MA 02645 | 2017-10-26 |
| Find all providers with the same taxonomy | ||||
| City | GLOUCESTER |
| Zip Code | 01930 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.