COMMONWEALTH MEDICINE (NPI# 1770142945) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770142945 |
| Entity Type | Organization |
| Organization Name | COMMONWEALTH MEDICINE |
| Practice Address |
55 Lake Ave N Worcester MA 01655-0002 |
| Mailing Address |
529 Main St Fl 3 Charlestown MA 02129-1125 |
| Practice Telephone | 6178868264 |
| Mailing Telephone | 6178868264 |
| Enumeration Date | 2019-06-11 |
| Last Update Date | 2019-06-11 |
| Authorized Official Name | ROSEMARIE BONAVENTURA (DEPUTY DIRECTOR) |
| Authorized Official Telephone | 6178868013 |
| Is Organization Subpart | Y |
| Parent Organization Name | UNIVERSITY OF MASSACHUSETTS MEDICAL SCHOOL |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QP0905X |
Clinic/Center Specialization: Public Health, State or Local |
Ambulatory Health Care Facilities | ||
| Y | 251K00000X | Public Health or Welfare | Agencies |
| Other Name | Type Code |
|---|---|
| CWM - Vaccine Program | Doing Business As Name - Organization |
| 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 | 251K00000X |
| Grouping | Agencies |
| Classification | Public Health or Welfare |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043695794 | Ethiopian Dream Center Inc. | Public Health or Welfare | 18a Millbury St, Worcester, MA 01610-2812 | 2015-07-23 |
| 1467539957 | City of Worcester | Public Health or Welfare | 25 Meade Street, Worcester, MA 01610 | 2006-11-01 |
| 1134534563 | Individual | Public Health or Welfare | 81 Plantation Street, Worcester, MA 01604 | 2014-06-24 |
| 1326092537 | Cedar Street Family Clinic Inc. | Public Health or Welfare | 340 Main St, Worcester, MA 01608-1604 | 2006-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871104240 | Town of Abington | Public Health or Welfare | 500 Gliniewicz Way Rm 109, Abington, MA 02351-2058 | 2020-08-11 |
| 1497379804 | Maasha Trust | Public Health or Welfare | 16 Edgemoor Cir Unit 16, Wellesley, MA 02482-1056 | 2020-06-01 |
| 1881159119 | Sorel Bertrand | Public Health or Welfare | 109 Rogers Dr, Stoughton, MA 02072-3208 | 2019-01-31 |
| 1023567070 | Preparatory Rehabilitation for Individual Development and Employment | Public Health or Welfare | 3 Maple Street, Taunton, MA 02870 | 2016-09-30 |
| 1922450220 | Mobile Dental Hygiene Services, LLP | Public Health or Welfare | 14 Jan Sebastian Dr Ste C, Sandwich, MA 02563-2384 | 2016-07-11 |
| 1447609722 | Myh, Inc. | Public Health or Welfare | 27-43 Wormwood St, 6th Floor, Boston, MA 02210-1619 | 2016-06-08 |
| 1083097216 | Visiting Dental Hygiene Associates, Inc. | Public Health or Welfare | 4 Keith Way Ste 3, Hingham, MA 02043-4258 | 2015-07-07 |
| 1306189766 | Pyramidion LLC | Public Health or Welfare | 2 Grafton Cmn, Grafton, MA 01519-1534 | 2013-04-03 |
| 1528310265 | Junior Paris | Public Health or Welfare | 284 N Franklin St, Holbrook, MA 02343-1146 | 2012-10-04 |
| 1306115753 | Greenfield Health Department | Public Health or Welfare | 14 Court Sq, Greenfield, MA 01301-3547 | 2011-12-14 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on COMMONWEALTH MEDICINE.
| 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.