NPIMap

Organization Active NPI

Umass Memorial Medical Group, Inc.

  • Ophthalmology Physician
  • Holden, MA
National Provider Identifier
1013227768
Registry record updated Oct 15, 2010
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Key facts

NPPES NPI Registry
Primary specialty
Ophthalmology PhysicianTaxonomy code 207W00000X
License
24170 Issued in MA
Legal business name
UMASS MEMORIAL MEDICAL GROUP, INC.
Practice address
61 Boyden Rd
Holden, MA 01520-2542
Phone
(508) 829-9944
Fax
(508) 829-2100
NPI assigned
Oct 15, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michele Streeter
Title
Executive Director
Phone
(508) 334-0311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ophthalmology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207W00000X 24170 MA Primary

Addresses

Primary practice location

61 Boyden Rd
Holden, MA 01520-2542

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885

National Provider Directory

National Provider Directory

Locations

61 Boyden Rd
Holden, MA 01520
Phone (508) 829-0330

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1287100800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287100800000",
    "number": "1013227768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885",
            "fax_number": "508-334-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "61 BOYDEN RD",
            "city": "HOLDEN",
            "state": "MA",
            "postal_code": "015202542",
            "telephone_number": "508-829-9944",
            "fax_number": "508-829-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UMASS MEMORIAL MEDICAL GROUP, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-15",
        "last_updated": "2010-10-15",
        "status": "A",
        "authorized_official_last_name": "STREETER",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "508-334-0311"
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Ophthalmology",
            "state": "MA",
            "license": "24170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holden, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.