UMASS MEMORIAL MEDICAL CENTER, INC (NPI# 1679131361) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679131361 |
| Entity Type | Organization |
| Organization Name | UMASS MEMORIAL MEDICAL CENTER, INC |
| Practice Address |
55 Lake Ave N Worcester MA 01655-0002 |
| Mailing Address |
Po Box 415353 Boston MA 02241-5353 |
| Practice Telephone | 5083341000 |
| Mailing Telephone | 5083341840 |
| Enumeration Date | 2019-05-29 |
| Last Update Date | 2019-05-29 |
| Authorized Official Name | MARILYN AMAYA (PROVIDER ENROLLMENT SPECIALIST) |
| Authorized Official Telephone | 5083346503 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 133VN1004X |
Dietitian, Registered Specialization: Nutrition, Pediatric |
Dietary & Nutritional Service Providers | ||
| N | 133VN1005X |
Dietitian, Registered Specialization: Nutrition, Renal |
Dietary & Nutritional Service Providers | ||
| N | 133VN1006X |
Dietitian, Registered Specialization: Nutrition, Metabolic |
Dietary & Nutritional Service Providers | ||
| Y | 133V00000X | Dietitian, Registered | Dietary & Nutritional Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891864039 | Umass Memorial Medical Center, Inc | Pharmacy | 55 Lake Ave N, Worcester, MA 01655-0002 | 2006-11-06 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | UMASS MEMORIAL MEDICAL CENTER, INC. | One Biotech, 365 Plantation Street, Worcester, MA 01605 |
| Street Address |
55 LAKE AVE N |
| City | WORCESTER |
| State | MA |
| Zip Code | 01655-0002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477556587 | James E Liebmann | Internal Medicine | 55 Lake Ave N, Hematology/oncology, Worcester, MA 01655-0002 | 2005-05-23 |
| 1518568732 | Justin Bullard | Psychologist | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-11-04 |
| 1346849825 | Meghan Moore | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-10-26 |
| 1174122899 | Jessica Goncalves Ferreira | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-10-23 |
| 1235746686 | Desiree Mytych | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-09-29 |
| 1659986248 | Rebecca Lynn Harris | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-09-10 |
| 1639781487 | Gabriella Kathleen Holland | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-21 |
| 1730791898 | Kerry Anne Benedict | Speech-Language Pathologist | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-20 |
| 1902418999 | Natasha R. Turner | Genetic Counselor, MS | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-20 |
| 1144830712 | Abbey Corsini | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205489713 | Darryl Sweeper Jr. | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Psychiatry, Umass Memorial Medical Center, Worcester, MA 01655 | 2019-07-23 |
| 1225690530 | Ryan Zenevitch | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Family Medicine, Umass Memorial Medical Center, Worcester, MA 01655 | 2019-07-08 |
| 1932688454 | Victoria Sayeg | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Pediatrics, Worcester, MA 01655 | 2018-08-07 |
| 1114425675 | Judith Dio Wentzell | Social Worker | Umassmemorial Medical Center, 55 Lake Ave North, Dept of Care Coordination, Worcester, MA 01655 | 2018-01-30 |
| 1861927386 | Muhammad Waqas Khan | Student in an Organized Health Care Education/Training Program | University of Massachusetts 55 North Lake Ave, Neurology, Worcester, MA 01655 | 2017-04-21 |
| 1861806192 | Qaiser Shamshir Khan | Psychiatry & Neurology | 55 Lake Ave N # S7-831, Worcester, MA 01655 | 2014-06-14 |
| 1073858981 | Heidi Glover | Nurse Practitioner | 55 Lake Ave North Dept. of Pedi-adolescent, Ummc University Campus, Worcester, MA 01655 | 2012-12-04 |
| 1972867992 | Anna Bjornsdottir | Psychiatry & Neurology | 55 Lake Av N, Worcester, MA 01655 | 2012-06-25 |
| 1245567676 | Steven Edward Mckinley | Nurse Practitioner | 55 Lake Ave. North, Umass Memorial Medical Center University Campus, Worcester, MA 01655 | 2009-11-05 |
| 1851582951 | Robin I Davidson | Neurological Surgery | 55 Lake Ave, North, Ummhc-univ Campus, Worcester, MA 01655 | 2007-08-05 |
| Find all providers in zip 01655 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235755653 | Michael Niejadlik | Dietitian, Registered | 288 Grove St, Worcester, MA 01605-3934 | 2020-06-22 |
| 1548880339 | Megan Casey Flannery | Dietitian, Registered | 123 Summer St Ste 125, Worcester, MA 01608-1216 | 2020-04-21 |
| 1629543467 | Sharon Chan | Dietitian, Registered | 55 Lake Ave N # Ac2-200, Worcester, MA 01655-0002 | 2018-10-08 |
| 1205377157 | Ilene Torchia | Dietitian, Registered | 98 Boyd St Apt 2, Worcester, MA 01606-2706 | 2017-03-12 |
| 1023560703 | Colleen Daly | Dietitian, Registered | 60 Wrentham Rd, Worcester, MA 01602-1322 | 2016-10-28 |
| 1194175372 | Jennifer Newman | Dietitian, Registered | Stability Health, 120 Front Street, Suite 440, Worcester, MA 01608 | 2016-06-17 |
| 1508278706 | Susan Miller | Dietitian, Registered | 371 Wildwood Ave, Worcester, MA 01603-1655 | 2014-05-22 |
| 1588971832 | Patricia Puntumapanitch | Dietitian, Registered | 85 4th St, Worcester, MA 01602-3193 | 2010-09-08 |
| 1073836565 | Inmay P. Macneil | Dietitian, Registered | 5 Neponset St Fl 12, Worcester, MA 01606-2714 | 2010-03-11 |
| 1255473567 | Elizabeth Ann Eckert | Dietitian, Registered | 120 Front Street, Suite 440, Worcester, MA 01608 | 2007-02-13 |
| Find all providers in WORCESTER | ||||
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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.