FORM HEALTH ASSOCIATES (MA), P.C. (NPI# 1386260594) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386260594 |
| Entity Type | Organization |
| Organization Name | FORM HEALTH ASSOCIATES (MA), P.C. |
| Practice Address |
179 Lincoln St Ste 404 Boston MA 02111-2425 |
| Practice Telephone | 6175051520 |
| Mailing Telephone | 6175051520 |
| Enumeration Date | 2020-06-23 |
| Last Update Date | 2020-06-23 |
| Authorized Official Name | MR. DEREK STEVEN ROWLEY (SR. DIR. OF OPERATIONS) |
| Authorized Official Telephone | 4042734596 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| Y | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians |
| Street Address |
179 LINCOLN ST STE 404 |
| City | BOSTON |
| State | MA |
| Zip Code | 02111-2425 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689271397 | Maximilian Richert | Counselor | 25 Kingston St, 4r, Boston, MA 02111 | 2020-10-06 |
| 1558978957 | Tien-hsin Chang | Student in an Organized Health Care Education/Training Program | 1 Kneeland Street (tufts University School of Dental Me, Boston, MA 02111 | 2020-09-29 |
| 1548883465 | Elizabeth Carter Stapleton | Dentist | Tufts School of Dental Medicine: Dept of Orthodontics, 1 Kneeland Street, Boston, MA 02111 | 2020-05-27 |
| 1932729597 | Jacob Joseph Kosarchuk | Neurological Surgery | 800 Washington Street, Proger 7, Boston, MA 02111 | 2020-04-23 |
| 1164051868 | Daniele Abela | Surgery | 860 Washington Street, South Building, 4th Floor, Boston, MA 02111 | 2020-04-04 |
| 1184265258 | Jade Orthodontics | Dentist | 30 Kneeland St, Suite 301, Boston, MA 02111 | 2019-09-30 |
| 1932753639 | Loukia Kamille Danaf | Student in an Organized Health Care Education/Training Program | 1 Kneeland Street, Tufts University School of Dental Me, Boston, MA 02111 | 2019-07-31 |
| 1033771944 | Faris Khalifa | Student in an Organized Health Care Education/Training Program | 1 Kneeland Street, 5th Floor, Boston, MA 02111 | 2019-07-01 |
| 1609437276 | Blair Hanna Ray Farbstein | Student in an Organized Health Care Education/Training Program | 1 Kneeland Street, 3rd Floor, Boston, MA 02111 | 2019-06-25 |
| 1821658709 | Jennifer Drummond | Internal Medicine | 800 Washington St. Gme Office, Boston, MA 02111 | 2019-06-13 |
| Find all providers in zip 02111 | ||||
| Taxonomy Code | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| 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 Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447604590 | Denise H. Wong | Internal Medicine | 720 Harrison Ave Ste 8100, Boston, MA 02118-2371 | 2016-04-14 |
| 1518334515 | Stephany Khalil Matta | Internal Medicine | 75 Kneeland St Lbby 5, Boston, MA 02111-1906 | 2015-08-25 |
| 1972982205 | Karen Mccloskey | Internal Medicine | 110 Francis St Ste 6a, Boston, MA 02215-5501 | 2015-05-19 |
| 1568873230 | Eric David Nolen-doerr | Internal Medicine | 720 Harrison Ave Ste 801, Boston, MA 02118-2326 | 2014-05-15 |
| 1770809147 | Sylvia Kehlenbrink Oh | Internal Medicine | 221 Longwood Avenue, Rfb-2, Bwh, Endocrinology, Diabetes and Hypertension, Boston, MA 02115 | 2010-04-10 |
| 1164746178 | Courtney Nagel Sandler | Internal Medicine | 221 Longwood Ave # Rfb2, Boston, MA 02115-5804 | 2010-03-19 |
| 1265767263 | Joel F Habener | Internal Medicine | Mgh Lab Endocrine, 55 Fruit St. Wellman 306, Boston, MA 02114 | 2009-10-08 |
| 1972741866 | Melanie Schorr Haines | Internal Medicine | Zero Emerson Place, Suite 112, Neuroendocrine Clinical Center, Boston, MA 02114 | 2009-01-30 |
| 1689833386 | Adi Barlev-ehrenberg | Internal Medicine | 221 Longwood Ave Fl 2, Brigham & Women's Hospital, Dept. of Endocrinology, Boston, MA 02115-5804 | 2008-06-06 |
| 1699896753 | Michael Rosenblatt | Internal Medicine | Tufts University School of Medicine, 136 Harrison Avenue, Boston, MA 02111-1800 | 2007-04-03 |
| Find all providers in BOSTON | ||||
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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.