DR. MICHAEL HERCULES THEODOULOU (NPI# 1760430755) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1760430755 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL HERCULES THEODOULOU |
| Credential | D.P.M. |
| Practice Address |
230 Highland Ave Somerville MA 02143-1408 |
| Practice Telephone | 6176651000 |
| Mailing Telephone | 6176651000 |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2011-12-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 213E00000X | Podiatrist | 2358 | MA | Podiatric Medicine & Surgery Service Providers |
| N | 213E00000X | Podiatrist | 01073 | MD | Podiatric Medicine & Surgery Service Providers |
| N | 213E00000X | Podiatrist | PO558 | DC | Podiatric Medicine & Surgery Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 110084502A | 05 |
| Street Address |
230 HIGHLAND AVE |
| City | SOMERVILLE |
| State | MA |
| Zip Code | 02143-1408 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760481501 | Michael Clarence Payne | Internal Medicine | 230 Highland Ave, Somerville Hospital / The Cambridge Health Alliance, Somerville, MA 02143-1408 | 2005-07-14 |
| 1336615319 | Brusly Guerrier | Registered Nurse | 230 Highland Ave, Somerville, MA 02143-1408 | 2018-10-17 |
| 1366935975 | Khushbu Patel | Licensed Vocational Nurse | 230 Highland Ave, Somerville, MA 02143-1408 | 2018-06-08 |
| 1922509496 | Eri Sugiyama Purdon | Occupational Therapist | 230 Highland Ave, Somerville, MA 02143-1408 | 2018-02-21 |
| 1902305576 | Orlando Leandro Perez-bonilla | Technician | 230 Highland Ave, Somerville, MA 02143-1408 | 2018-02-08 |
| 1720595846 | Daisy Tirado | Licensed Practical Nurse | 230 Highland Ave, Somerville, MA 02143-1408 | 2018-01-10 |
| 1134640105 | Claudine Alabre | Registered Nurse | 230 Highland Ave, Somerville, MA 02143-1408 | 2017-06-29 |
| 1750814620 | Julie Ng | Licensed Practical Nurse | 230 Highland Ave, Somerville, MA 02143-1408 | 2017-04-07 |
| 1619429032 | Giselle Devane | Health Educator | 230 Highland Ave, Somerville, MA 02143-1408 | 2016-11-02 |
| 1033661145 | Debralee Quinn | Registered Nurse | 230 Highland Ave, Somerville Hospital, Somerville, MA 02143-1408 | 2016-10-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245843598 | Sidney Marie Joines | Counselor | New Washington St, Somerville, MA 02143 | 2020-08-26 |
| 1487295887 | Tejasvini Goud Jangam | Dentist | 14 Mcgrath Highway Twin City Plaza, Somerville, MA 02143 | 2019-10-07 |
| 1265900658 | Latoya Lewis | Massage Therapist | 343 Medford Street Suite 4b, Somerville, MA 02143 | 2018-11-05 |
| 1982181053 | Robert Lafollette | Social Worker | 61 Inner Belt Rd, Somerville, MA 02143 | 2018-07-23 |
| 1013405471 | Roseli De Fatima Schimanski | Acupuncturist | 10 Clark St #3, Somerville, MA 02143 | 2018-05-01 |
| 1255840070 | Maggie Kinser | Counselor | 366 Somerville Avenue, Somerville, MA 02143 | 2017-09-25 |
| 1497273742 | Isabelle Hackett | Social Worker | 17 Inner Belt Rd, Somerville, MA 02143 | 2017-09-07 |
| 1952824666 | Manuel Cantu | Counselor | 17 Inner Belt Road, Somerville, MA 02143 | 2017-07-25 |
| 1649710963 | Shakemia Shaw | Licensed Practical Nurse | 230 Highland Avenue, Somerville, MA 02143 | 2017-03-06 |
| 1245600501 | Libby Vilner | Social Worker | 12 Tyler St., Somerville, MA 02143 | 2015-09-30 |
| Find all providers in zip 02143 | ||||
| Taxonomy Code | 213E00000X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical and other operative procedures, prescribe corrective devices and prescribe and administer drugs and physical therapy. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871525253 | John Elijah Bell | Podiatrist | 305 Lake Dr, Somerville, TN 38068-9724 | 2006-07-07 |
| 1932105095 | Charles William Connolly | Podiatrist | 120 College Ave, Somerville, MA 02144-1919 | 2005-06-23 |
| 1801383088 | Candria Consulting and Holdings Inc | Podiatrist | 53 Main St, Somerville, MA 02145-1448 | 2018-04-13 |
| 1184860835 | Pasquale Cancelliere | Podiatrist | 53 Main St, Somerville, MA 02145-1448 | 2008-12-31 |
| 1588628853 | Brian D Tedesco | Podiatrist | 53 Main St, Somerville, MA 02145-1448 | 2006-04-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770052623 | Edward Joseph Salem | Podiatrist | 18 Hadley Village Rd Apt D, South Hadley, MA 01075-2272 | 2018-11-21 |
| 1497230171 | Coastal Foot & Ankle Inc | Podiatrist | 300 Hanover St Ste 2c, Fall River, MA 02720-5451 | 2018-09-28 |
| 1942794656 | Christopher H. Peteros, Dpm, LLC | Podiatrist | 1200 Converse St Ste 103, Longmeadow, MA 01106-1760 | 2018-06-16 |
| 1003309444 | Plymouth Podiatry PC | Podiatrist | 135 Sandwich St Ste 1, Plymouth, MA 02360-2400 | 2018-06-11 |
| 1972024735 | Richa Piyush Patel | Podiatrist | 100 Crossing Blvd Ste 300, Framingham, MA 01702-5555 | 2017-07-03 |
| 1508391186 | Steven Quan | Podiatrist | 70 Wesson Ave, Quincy, MA 02169-7412 | 2017-04-20 |
| 1598117350 | Melissa Lynn Ricci | Podiatrist | 100 Highland St Ste 122, Milton, MA 02186-3878 | 2016-07-05 |
| 1639528987 | Sturdy Memorial Associates, Inc | Podiatrist | 7 Wilkins Drive, Plainville, MA 02762 | 2016-06-08 |
| 1043669591 | Sara Elizabeth Rose-sauld | Podiatrist | 52 2nd Ave Ste 1150, Waltham, MA 02451-1129 | 2016-06-06 |
| 1558743880 | Alissa Kuizinas | Podiatrist | 54 Baker Avenue Ext Ste 301, Concord, MA 01742-2139 | 2015-06-23 |
| Find all providers with the same taxonomy | ||||
| City | SOMERVILLE |
| Zip Code | 02143 |
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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.