JOHN J. PODKOWA JR. (NPI# 1932373552) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932373552 |
| Entity Type | Individual |
| Full Name | JOHN J. PODKOWA JR. |
| Credential | D.O. |
| Practice Address |
208 Mill Rd Fairhaven MA 02719-5208 |
| Mailing Address |
200 Mill Rd Ste 180 Fairhaven MA 02719-5252 |
| Practice Telephone | 5089961800 |
| Practice Fax Number | 5089927906 |
| Mailing Telephone | 5089732000 |
| Mailing Fax Number | 5089732001 |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2020-04-23 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 239926 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 110082851A | 05 |
| Street Address |
208 MILL RD |
| City | FAIRHAVEN |
| State | MA |
| Zip Code | 02719-5208 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417956426 | Patricia L Andrade | Surgery | 208 Mill Rd, 2nd Floor, Fairhaven, MA 02719-5208 | 2005-07-20 |
| 1255931150 | Kristen Erin Medeiros | Nurse Practitioner | 208 Mill Rd, Fairhaven, MA 02719-5208 | 2020-10-29 |
| 1720687965 | Keri Mossman | Nurse Practitioner | 208 Mill Rd, Fairhaven, MA 02719-5208 | 2020-10-20 |
| 1710514708 | Emily Rochac Argueta | Surgery | 208 Mill Rd, Fairhaven, MA 02719-5208 | 2020-03-27 |
| 1821529215 | Christine J Manoli | Nurse Practitioner | 208 Mill Rd, Fairhaven, MA 02719-5208 | 2017-03-27 |
| 1700326840 | Erica Lynn Almeida | Physician Assistant | 208 Mill Rd, Fairhaven, MA 02719-5208 | 2017-03-07 |
| 1437695301 | Carolyn Ariel Duncan | Nurse Practitioner | 208 Mill Rd, Fairhaven, MA 02719-5208 | 2017-01-16 |
| 1053863126 | Sandra Hornig | Physician Assistant | 208 Mill Rd, Fairhaven, MA 02719-5208 | 2016-10-25 |
| 1437608841 | Michelle R. Freitas | Nurse Practitioner | 208 Mill Rd, Fairhaven, MA 02719-5208 | 2016-09-27 |
| 1457808024 | Hannah Bailey Raymond | Nurse Practitioner | 208 Mill Rd, Fairhaven, MA 02719-5208 | 2016-09-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457589772 | David Paul Patterson | Nurse Practitioner | 271 Alden Rd, Fairhaven, MA 02719 | 2009-06-25 |
| 1245415983 | Carol Ann Reeve | Social Worker | 21 Nelson Ave, Fairhaven, MA 02719 | 2007-12-31 |
| 1194842716 | Cathleen Lacy | Physical Therapist | 333 Bridge St, Fairhaven, MA 02719 | 2007-03-26 |
| 1700903978 | Barbara Ann Acksen | Psychologist | 91 Green Street, Fairhaven, MA 02719 | 2007-03-23 |
| 1811023260 | Merolla Chiropractic Inc | Chiropractor | 73 Alden Rd, Fairhaven, MA 02719 | 2007-02-27 |
| 1982746442 | Michele E Merolla | Chiropractor | 73 Aiden Rd, Fairhaven, MA 02719 | 2007-02-13 |
| 1417016338 | Brian K Bowcock | Chiropractor | 84 Huttleston Avenue, Fairhaven, MA 02719 | 2006-12-06 |
| 1104937697 | Southcoast Visiting Nurse Association. Inc | Home Health | 200 Mill Road, Suite 120, Fairhaven, MA 02719 | 2006-08-31 |
| 1902817299 | 184 Main LLC | Skilled Nursing Facility | 184 Main Street, Fairhaven, MA 02719 | 2006-08-11 |
| 1821584103 | Smiley Dental Care Pllc | Clinic/Center | 17 Berdon Way, Fairheaven, MA 02719 | 2018-07-10 |
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| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962462028 | Elliot A Lipstock | Internal Medicine | 276 Alden Rd, Fairhaven, MA 02719-4430 | 2006-03-24 |
| 1336137629 | Southcoast Physicians Group, Inc. | Internal Medicine | 200 Mill Road, Suite 180, Fairhaven, MA 02719-5252 | 2005-10-11 |
| 1679912539 | Michelle V Wong | Internal Medicine | 208 Mill Rd, Fairhaven, MA 02719-5208 | 2013-06-24 |
| 1528405685 | Robert Vazquez | Internal Medicine | 208 Mill Rd, Fairhaven, MA 02719-5208 | 2013-05-30 |
| 1528351772 | Albert Lin | Internal Medicine | 208 Mill Rd, Fairhaven, MA 02719-5208 | 2011-05-20 |
| 1760668487 | Brian D Cilley | Internal Medicine | 208 Mill Rd, Fairhaven, MA 02719-5252 | 2008-01-11 |
| 1770765505 | Suzelle S. Luc | Internal Medicine | 206 Mill Rd, Fairhaven, MA 02719-5208 | 2007-12-04 |
| 1679780761 | Michael R Kelly | Internal Medicine | 208 Mill Rd, Fairhaven, MA 02719-5208 | 2007-05-17 |
| 1366543225 | Abena A. Addo | Internal Medicine | 208 Mill Rd, Fairhaven, MA 02719-5208 | 2006-09-25 |
| 1477522290 | Chandra S Reddivari | Internal Medicine | 200 Mill Road, Suite 190, Fairhaven, MA 02719-5252 | 2006-03-15 |
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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.