Gunardi Nyoto Irawan (NPI# 1053752832, PAC ID# 1557648961) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1053752832 |
| PAC ID by PECOS | 1557648961 |
| Professional Enrollment ID | I20170511001317 |
| Full Name | Gunardi Nyoto Irawan |
| Organization Legal Name | UMASS MEMORIAL MEDICAL GROUP INC |
| Address |
1 W Boylston St Worcester MA 01605-3501 |
| Phone Number | 5088542636 |
| Gender | M |
| Graduation Year | 2011 |
| Primary Specialty | INTERNAL MEDICINE |
| Group Practice PAC ID | 4284539891 |
| Number of Group Practice Members | 1403 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 220163 | UMASS MEMORIAL MEDICAL CENTER/UNIVERSITY CAMPUS |
| 220176 | ST VINCENT HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 1 W Boylston St, Worcester, MA 01605-3501 | 5088542636 | UMASS MEMORIAL MEDICAL GROUP INC |
| Organization Legal Name | UMASS MEMORIAL MEDICAL GROUP INC |
| Physicians | 1450 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Pantea Ebrahimpour | Internal Medicine | Umass Memorial Medical Group Inc | 103 Millbury St, Auburn, MA 01501-3205 |
| Yonghyun Lee | Internal Medicine | Umass Memorial Medical Group Inc | 76 Summer St, Fitchburg, MA 01420-5783 |
| Amrutha Balakrishnan | Family Medicine | Umass Memorial Medical Group Inc | 640 Bolton St, Marlborough, MA 01752-3999 |
| Anupreet Oberoi | Family Medicine | Umass Memorial Medical Group Inc | 650 Boston Post Rd E, Marlborough, MA 01752-3724 |
| Mark Webster Maxfield | Thoracic Surgery | Umass Memorial Medical Group Inc | 67 Belmont St, Worcester, MA 01605-2657 |
| Barbara J Laforce | Nurse Practitioner | Umass Memorial Medical Group Inc | 47 Ashby State Rd, Fitchburg, MA 01420-2038 |
| Neety Patel | Family Medicine | Umass Memorial Medical Group Inc | 326 Nichols Rd, Fitchburg, MA 01420-5140 |
| Elizabeth B Pelkofski | Gynecological Oncology | Umass Memorial Medical Group Inc | 33 Kendall St, Worcester, MA 01605-2726 |
| Krunal Patel | Gastroenterology | Umass Memorial Medical Group Inc | 210 Lincoln St, Worcester, MA 01605-2529 |
| Sufan Vanessa Lin | Internal Medicine | Umass Memorial Medical Group Inc | 50 Leominster Rd, Sterling, MA 01564-2146 |
| Street Address |
1 W BOYLSTON ST |
| City | WORCESTER |
| State | MA |
| Zip | 01605-3501 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Bessie L Hazard | Internal Medicine | Umass Memorial Medical Group Inc | 1 W Boylston St, Worcester, MA 01605-3501 |
| Edward F Driscoll | Internal Medicine | Umass Memorial Medical Group Inc | 1 W Boylston St, Worcester, MA 01605-3501 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Michael A Cirillo | Psychologist, Clinical | Cornerstone Behavioral Health Inc. | 397 Grove St, Worcester, MA 01605-1223 |
| Peter W Moran | Psychologist, Clinical | Cornerstone Behavioral Health Inc. | 397 Grove St, Worcester, MA 01605-1223 |
| Theresa G Boothby | Nurse Practitioner | Minuteclinic Diagnostic of Massachusetts, LLC | 44 W Boylston St, Worcester, MA 01605-1261 |
| Kathryn A Mcgrath | Nurse Practitioner | Minuteclinic Diagnostic of Massachusetts, LLC | 44 W Boylston St, Worcester, MA 01605-1261 |
| Lea C Murphy | Nurse Practitioner | Minuteclinic Diagnostic of Massachusetts, LLC | 44 W Boylston St, Worcester, MA 01605-1261 |
| Leena S Shah | Nurse Practitioner | Minuteclinic Diagnostic of Massachusetts, LLC | 44 W Boylston St, Worcester, MA 01605-1261 |
| Daylin A. Chaplin | Nurse Practitioner | Minuteclinic Diagnostic of Massachusetts, LLC | 44 W Boylston St, Worcester, MA 01605-1261 |
| Lauren E Gray | Nurse Practitioner | Minuteclinic Diagnostic of Massachusetts, LLC | 44 W Boylston St, Worcester, MA 01605-1261 |
| Lisa A Mcniff | Nurse Practitioner | Minuteclinic Diagnostic of Massachusetts, LLC | 44 W Boylston St, Worcester, MA 01605-1261 |
| Eric M Severi | Nurse Practitioner | Minuteclinic Diagnostic of Massachusetts, LLC | 44 W Boylston St, Worcester, MA 01605-1261 |
| Find all physicians in zip 01605 | |||
| City | WORCESTER |
| Zip Code | 01605 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | WORCESTER + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Gunardi Nyoto Irawan.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.