UMASS MEMORIAL MEDICAL CENTER (NPI# 1679791339) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1679791339 |
| Entity Type | Organization |
| Organization Name | UMASS MEMORIAL MEDICAL CENTER |
| Practice Address |
55 Lake Ave North Worcester MA 01655 |
| Mailing Address |
365 Plantation Street Worcester MA 01604 |
| Practice Telephone | 5083340254 |
| Mailing Telephone | 5083340254 |
| Enumeration Date | 2007-04-20 |
| Last Update Date | 2007-07-11 |
| Authorized Official Name | MR. TODD KEATING (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 5083340254 |
| Is Organization Subpart | Y |
| Parent Organization Name | UMASS MEMORIAL MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
MA | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649334269 | Umass Memorial Medical Center | General Acute Care Hospital | 37 Amherst St, Apt #3, Worcester, MA 01602-2009 | 2006-12-20 |
| 1346626553 | Umass Memorial Medical Center | General Acute Care Hospital | 119 Belmont St, Worcester, MA 01605-2903 | 2015-08-11 |
| 1306238449 | Umass Memorial Medical Center | Clinic/Center | 55 Lake Ave N, Worcester, MA 01655-0002 | 2015-02-26 |
| 1891115861 | Umass Memorial Medical Center | General Acute Care Hospital | 55 Lake Ave N, Worcester, MA 01655-0002 | 2014-04-17 |
| 1356670293 | Umass Memorial Medical Center | Clinic/Center | 119 Belmont St, New England Hemophilia Center At Umass Memorial, Worcester, MA 01605-2903 | 2009-12-23 |
| 1679574933 | Umass Memorial Medical Center | Pharmacy | 55 Lake Ave N, Worcester, MA 01655-0002 | 2005-08-09 |
| 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 NORTH |
| City | WORCESTER |
| State | MA |
| Zip Code | 01655 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407894777 | David A Phillips | Radiology | 55 Lake Ave North, Umass Memorial/radiology, Worcester, MA 01655 | 2006-06-02 |
| 1184094872 | Umass Memorial Group | General Acute Care Hospital | 55 Lake Ave North, Worcester, MA 01655 | 2015-10-07 |
| 1104134402 | Mary Ann Badon | Orthopaedic Surgery | 55 Lake Ave North, Worcester, MA 01655 | 2010-09-21 |
| 1235347808 | Krishna V Shroff | Pharmacist | 55 Lake Ave North, University of Massachusetts Memorial Medical Center, Worcester, MA 01655 | 2007-05-18 |
| 1396895603 | Susan N Bol | Dietitian, Registered | 55 Lake Ave North, Ummhc, Worcester, MA 01655 | 2007-01-11 |
| 1255488383 | David L. Polan | Emergency Medicine | 55 Lake Ave North, Department of Emergency Medicine, Worcester, MA 01655 | 2007-01-04 |
| 1881767416 | John Albert Beauchesne | Physician Assistant | 55 Lake Ave North, Umass Memorial Health Care Dept of Adolescent Medicine, Worcester, MA 01605 | 2006-11-15 |
| 1801977640 | Jay G. Fong | Pediatrics | 55 Lake Ave North, Worcester, MA 01655 | 2006-10-18 |
| 1164511648 | Corey D Harrison | Emergency Medicine | 55 Lake Ave North, Department of Emergency Medicine, Worcester, MA 01655-0000 | 2006-10-12 |
| 1548375207 | Sheyda Namazie-kummer | Pediatrics | 55 Lake Ave North, U Mass Memorial Medical Ctr, Pediatric Hospitalist Grp, Worcester, MA 01655 | 2006-08-20 |
| 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 | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295039196 | Healthworks Med Group of Massachusetts P C | Clinic/Center | 440 Lincoln St, Worcester, MA 01653 | 2011-01-06 |
| 1982875787 | Frederic H. Schwartz, Md, PC | Clinic/Center | 255 Park Ave Ste 210, Worcester, MA 01609-1985 | 2008-03-19 |
| 1174559363 | Franciscos. Gil M.d., PC | Clinic/Center | 10 Winthrop St., Worcester, MA 01604 | 2006-06-23 |
| 1295279172 | Professional Medical Center, P.C. | Clinic/Center | 65 Milton St, Worcester, MA 01606-2819 | 2016-12-12 |
| 1295149664 | Wpi Health & Wellness Services | Clinic/Center | 100 Institute Rd, Worcester, MA 01609-2280 | 2014-06-13 |
| 1104070564 | Community Health Link | Clinic/Center | 72 Jacques Ave, Worcester, MA 01610-2476 | 2008-11-12 |
| 1376709683 | Internal Medicine and Endocrinology, Inc. | Clinic/Center | 255 Park Ave, Suite 210, Worcester, MA 01609-1953 | 2008-08-06 |
| 1225213481 | J Leitao-pina Md PC | Clinic/Center | 299 Lincoln St, Suite 201, Worcester, MA 01605-3646 | 2008-01-07 |
| 1518971860 | Primary Physician Partners | Clinic/Center | 123 Summer St, Suite 385n, Worcester, MA 01608-1216 | 2006-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780246058 | Elaine Skawski Np, LLC | Clinic/Center | 10 Hospital Dr Ste 311, Holyoke, MA 01040-6603 | 2019-07-08 |
| 1306403613 | Compassionate Care Physicians LLC | Clinic/Center | 9 Mill and Main Pl Ste 101, Maynard, MA 01754-2651 | 2019-05-22 |
| 1245721240 | Zaheen Medical Center LLC | Clinic/Center | 231 Sutton St Ste 1a, North Andover, MA 01845-1620 | 2018-05-24 |
| 1982102265 | Jacob Louis Perriello | Clinic/Center | 12 Drew Ave, Weymouth, MA 02189-2226 | 2018-02-01 |
| 1407385834 | Lawrence Health Solutions, LLC | Clinic/Center | 25 Marston St., Suite 105, Lawrence, MA 01841 | 2017-06-08 |
| 1962949925 | Regis College | Clinic/Center | 155 Wheeler Circle, Apt. 273, Stoughton, MA 02072 | 2017-01-27 |
| 1154866234 | Sokharith Mey, Md, Pllc | Clinic/Center | 280 Union St # 402, Lynn, MA 01901-1353 | 2016-12-28 |
| 1558721191 | Harbor Health Services Inc | Clinic/Center | 735 Attucks Lane, Hyannis, MA 02601 | 2016-02-24 |
| 1669830550 | Nirphemy Dambreville-lundy | Clinic/Center | 125 Gas Light Dr, 8, Weymouth, MA 02190-2142 | 2016-02-05 |
| 1891125480 | Western Massachusetts Primary Care PC | Clinic/Center | 405 Armory St, Springfield, MA 01104-2305 | 2013-11-18 |
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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.