DR. BOUTROS MICHEL GHASSIBI (NPI# 1184723819) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184723819 |
| Entity Type | Individual |
| Full Name | DR. BOUTROS MICHEL GHASSIBI |
| Credential | MD |
| Practice Address |
34 Haverhill St Lawrence MA 01841-2884 |
| Practice Telephone | 9786860090 |
| Practice Fax Number | 9786815963 |
| Mailing Telephone | 9786860090 |
| Mailing Fax Number | 9786815963 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2017-11-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207QS0010X |
Family Medicine Specialization: Sports Medicine |
72138 | MA | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 72138 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 3166724 | 05 |
| Street Address |
34 HAVERHILL ST |
| City | LAWRENCE |
| State | MA |
| Zip Code | 01841-2884 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427054493 | Christopher Matthew Bositis | Family Medicine | 34 Haverhill St, Lawrence, MA 01841-2884 | 2005-06-24 |
| 1669089942 | Ashley Melissa Guillen | Registered Nurse | 34 Haverhill St, Lawrence, MA 01841-2884 | 2020-09-30 |
| 1952918252 | Rene Daniel Scarone | Registered Nurse | 34 Haverhill St, Lawrence, MA 01841-2884 | 2020-09-30 |
| 1891302121 | Kathleen M. Oneill | Registered Nurse | 34 Haverhill St, Lawrence, MA 01841-2884 | 2020-09-30 |
| 1437766706 | Natalia Magbe Vargas Sanchez | Registered Nurse | 34 Haverhill St, Lawrence, MA 01841-2884 | 2020-09-30 |
| 1205443629 | Jennifer Michelle Mora | Registered Nurse | 34 Haverhill St, Lawrence, MA 01841-2884 | 2020-09-29 |
| 1952918385 | Katherine Pena | Licensed Practical Nurse | 34 Haverhill St, Lawrence, MA 01841-2884 | 2020-09-29 |
| 1356958029 | Juanita Saenz Bilbao | Registered Nurse | 34 Haverhill St, Lawrence, MA 01841-2884 | 2020-09-28 |
| 1578170346 | Jill Ells-o'brien | Licensed Practical Nurse | 34 Haverhill St, Lawrence, MA 01841-2884 | 2020-09-25 |
| 1316554223 | Edelmira Nunez | Registered Nurse | 34 Haverhill St, Lawrence, MA 01841-2884 | 2020-09-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326502501 | Toby Lazerson | Social Worker | 135 Butler Street, Bruce School, Lawrence, MA 01841 | 2019-01-22 |
| 1376038414 | Maggie Townsend | Physical Therapist | 172 Lawrence Street, Lawrence, MA 01841 | 2018-06-29 |
| 1265941678 | Melvinson Polanco | Psychologist | 170 Sanborn St, Lawrence, MA 01841 | 2017-09-28 |
| 1407385834 | Lawrence Health Solutions, LLC | Clinic/Center | 25 Marston St., Suite 105, Lawrence, MA 01841 | 2017-06-08 |
| 1619419652 | Helen Santos | Social Worker | 5 Colby St, Lawrence, MA 01841 | 2016-11-08 |
| 1740737329 | James Michael Torres | Social Worker | 439 S. Union Street, Larwrence, MA 01841 | 2016-09-01 |
| 1588010003 | Michael Castillo | Counselor | 274 East Haverhill St, Lawrence, MA 01841 | 2016-05-13 |
| 1619379351 | Marlene Reyes | Psychologist | 27 Clarke St, Lawrence, MA 01841 | 2014-09-25 |
| 1982016762 | Erica Vasquez | Counselor | 590 Canal Street, Lawrence, MA 01841 | 2014-05-28 |
| 1538500202 | Azadeh Suppappola | Optometrist | 25 Marston Street #104, Boston Eye Group, Lawrence, MA 01841 | 2013-07-10 |
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| Taxonomy Code | 207QS0010X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Sports Medicine |
| A family medicine physician that is trained to be responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the health care of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Family Medicine, 2007. http://www.theabfm.org/. American Osteopathic Board of Family Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508956301 | Lawrence M Magee | Family Medicine | Allen Fieldhouse, 1651 Naismith Dr., Lawrence, KS 66045-0001 | 2006-10-13 |
| 1649781709 | Lawrence Physicians LLC | Family Medicine | 1112 W 6th St Ste 124, Lawrence, KS 66044-2249 | 2017-10-17 |
| 1043624349 | Emily Nicole Heronemus | Family Medicine | 6265 Rock Chalk Dr, Suite 1500, Lawrence, KS 66049 | 2014-06-13 |
| 1609813005 | Orthokansas, LLC | Family Medicine | 1112 W 6th St, Suite 124, Lawrence, KS 66044-2215 | 2006-06-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619101052 | Miguel Angel Concepcion | Family Medicine | 250 Paradise Rd Unit 2203, Swampscott, MA 01907-2948 | 2009-05-13 |
| 1205839784 | Gail B Fayre | Family Medicine | 25 Highland Ave, Newburyport, MA 01950-3867 | 2005-05-27 |
| 1467983494 | Robert Dyer | Family Medicine | 915 Commonwealth Ave, Boston, MA 02215-1394 | 2017-03-22 |
| 1245612605 | Carla Marisa Basadre Quiroz | Family Medicine | 147 Pelham St, Methuen, MA 01844-2060 | 2015-06-22 |
| 1174961262 | Derek Lee | Family Medicine | 465 S Washington St, North Attleboro, MA 02760-2129 | 2013-06-11 |
| 1801129242 | The New England Center for Osteopathy, Pllc | Family Medicine | 2 South St, Suite 30, Pittsfield, MA 01201-6294 | 2009-09-17 |
| 1790946176 | Chad Beattie | Family Medicine | 531 Faunce Corner Rd, Dartmouth, MA 02747-1242 | 2008-06-19 |
| 1700045663 | Jennifer B. Schwartz | Family Medicine | 1101 Beacon St, 4 East, Brookline, MA 02446-5587 | 2008-06-05 |
| 1457537433 | Navid Mahooti | Family Medicine | 104 Endicott St, Suite 104, Danvers, MA 01923-3623 | 2008-01-21 |
| 1033316153 | Carolyn Saluti | Family Medicine | 281 Lincoln St, Med Staff Svcs, Worcester, MA 01605-2138 | 2007-07-02 |
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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.