HALLMARK HEALTH MEDICAL ASSOCIATES INC (NPI# 1770563900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1770563900 |
| Entity Type | Organization |
| Organization Name | HALLMARK HEALTH MEDICAL ASSOCIATES INC |
| Other Organization Name | ELL POND MEDICAL ASSOCIATES INC |
| Practice Address |
170 Governors Ave Attn: Provider Enrollment Medford MA 02155-1643 |
| Mailing Address |
Po Box 3237 Woburn MA 01888-3237 |
| Practice Telephone | 7813387521 |
| Practice Fax Number | 7813387531 |
| Mailing Telephone | 7813387170 |
| Mailing Fax Number | 7813387173 |
| Enumeration Date | 2006-01-23 |
| Last Update Date | 2009-11-18 |
| Authorized Official Name | MR. MICHAEL S TURILLI (VICE PRESIDENT FISCAL SERVICES) |
| Authorized Official Telephone | 7813387415 |
| Is Organization Subpart | Y |
| Parent Organization Name | HALLMARK HEALTH COPORATION |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians | ||
| N | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians | ||
| N | 208600000X | Surgery | Allopathic & Osteopathic Physicians | ||
| N | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 367A00000X | Advanced Practice Midwife | Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians | ||
| N | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
Allopathic & Osteopathic Physicians | ||
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LX0001X |
Nurse Practitioner Specialization: Obstetrics & Gynecology |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | BLUE CROSS GROUP PROV # | M15828 | 01 |
| MA | 9771336 | 05 |
| Other Name | Type Code |
|---|---|
| Ell Pond Medical Associates Inc | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255964391 | Hallmark Health Medical Associates Inc | Psychologist | 170 Governors Ave, Medford, MA 02155-1643 | 2020-02-18 |
| 1568789527 | Hallmark Health Medical Associates Inc | Surgery | 170 Governors Ave, Attn: Provider Enrollment-hhma (3) Contact, Medford, MA 02155-1643 | 2010-04-29 |
| 1942450242 | Hallmark Health Medical Associates Inc | Obstetrics & Gynecology | 170 Governors Ave, Hallmark Health Medical Associates Inc (#2)-non-pchi, Medford, MA 02155-1643 | 2008-09-23 |
| Street Address |
170 GOVERNORS AVE ATTN: PROVIDER ENROLLMENT |
| City | MEDFORD |
| State | MA |
| Zip Code | 02155-1643 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841290467 | Melrosewakefield Healthcare, Inc. | General Acute Care Hospital | 170 Governors Ave, Medford, MA 02155-1643 | 2005-07-26 |
| 1255964391 | Hallmark Health Medical Associates Inc | Psychologist | 170 Governors Ave, Medford, MA 02155-1643 | 2020-02-18 |
| 1205473592 | Melrosewakefield Healthcare, Inc. | Clinic/Center | 170 Governors Ave, Medford, MA 02155-1643 | 2019-12-05 |
| 1801431754 | John Norcross | Occupational Therapist | 170 Governors Ave, Medford, MA 02155-1643 | 2019-11-14 |
| 1770029670 | Kayla Rose | Registered Nurse | 170 Governors Ave, Medford, MA 02155-1643 | 2017-01-16 |
| 1326403809 | Ying Ma | Nurse Practitioner | 170 Governors Ave, Medford, MA 02155-1643 | 2015-12-28 |
| 1396143624 | Laurie Young | Nurse Practitioner | 170 Governors Ave, Medford, MA 02155-1643 | 2014-12-19 |
| 1912325754 | Yesodarao and Associates LLC | Internal Medicine | 170 Governors Ave, Medford, MA 02155-1643 | 2014-03-30 |
| 1124364872 | Andrea Messina | Nurse Practitioner | 170 Governors Ave, Medford, MA 02155-1643 | 2012-12-28 |
| 1124362389 | Michelle Vidal | Social Worker | 170 Governors Ave, Lawrence Memorial Hospital, Medford, MA 02155-1643 | 2012-11-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679113922 | Elena Chapman | Nurse Practitioner | 293 Salem St 4, Medford, MA 02155 | 2020-01-14 |
| 1922658830 | Michelle Anne Zona | Counselor | 100 George Hassett Dr, Medford, MA 02155 | 2019-09-13 |
| 1487138509 | Dava Davainis | Social Worker | 76 Newbern Avenue, Apt. 1, Medford, MA 02155 | 2018-09-25 |
| 1265915128 | Erin Roberts | Counselor | Medford Public Schools, 3002 Mystic Valley Pkwy, Medford, MA 02155 | 2018-09-07 |
| 1871075739 | Janice Madeline Cole | Social Worker | 3820 Mystic Valley Pkwy Unit 805, Medford, MA 02155 | 2018-09-06 |
| 1447732573 | Mystick Women's Health, Inc. | Obstetrics & Gynecology | 13 Bradlee Road, Medford, MA 02155 | 2018-09-05 |
| 1144713090 | Laura Rogers | Psychologist | 203 Paige Hall, 12 Upper Campus Road, Medford, MA 02155 | 2018-06-14 |
| 1871086694 | Shuo Yang | Dentist | 8 9th St Apt 310, Medford, MA 02155 | 2018-06-07 |
| 1891287108 | Xuhua Qin | Psychologist | 120 Curtis Street, Medford, MA 02155 | 2018-06-01 |
| 1568953529 | Cvs Pharmacy, Inc. | Durable Medical Equipment & Medical Supplies | 471 Salem St, Medford, MA 02155 | 2018-05-25 |
| Find all providers in zip 02155 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346847332 | Jasmine Barnhart | Family Medicine | 1935 Canyon Ave, Medford, OR 97504-2128 | 2020-10-03 |
| 1831742667 | Mallory Marie Morton | Family Medicine | 429 Main St # 3, Medford, MA 02155-6571 | 2019-07-21 |
| 1841619418 | Andrew Thomas Gomez | Family Medicine | 131 Rte 70 W, Ste 100, Medford, NJ 08055 | 2014-04-10 |
| 1992140313 | Stephanie Guido | Family Medicine | 128 Route 70 Ste Aandb, Medford, NJ 08055-2371 | 2013-04-30 |
| 1316214281 | Carl Russell Griesser | Family Medicine | 555 Black Oak Drive, Suite 100, Medford Medical Clinic, Medford, OR 97504 | 2011-11-21 |
| 1649591223 | Wesley T Ramoso | Family Medicine | 3225 Hillcrest Park Dr, Medford, OR 97504-7657 | 2010-06-17 |
| 1891945812 | Amy Holmes Medical Services Plc | Family Medicine | 102 E Cherokee, Medford, OK 73759-1210 | 2008-09-26 |
| 1972793370 | Sowmya Reddy Thadisina | Family Medicine | 101 Main St Ste 214, Medford, MA 02155-4530 | 2007-07-31 |
| 1689890667 | James K Robinson II | Family Medicine | W5238 Jolly Ave, Medford, WI 54451-9303 | 2007-04-18 |
| 1316160658 | Island Medical of Medford, LLP | Family Medicine | 1647 Route 112, Medford, NY 11763-3635 | 2007-04-11 |
| Find all providers in MEDFORD | ||||
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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.