Individual provider Active NPI

Cassandra Dorvil, D.O.

  • Family Medicine Physician
  • Plymouth, MA
National Provider Identifier
1023457355
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
269265 Issued in MA
Practice address
110 Long Pond Rd Ste 101
Plymouth, MA 02360-2642
Phone
(508) 210-5850
NPI assigned
Jun 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X 269265 MA Primary

Addresses

Primary practice location

110 Long Pond Rd Ste 101
Plymouth, MA 02360-2642

Mailing address

110 Long Pond Rd Ste 101
Plymouth, MA 02360-2642

Other practice location 1

275 Nichols Rd
Fitchburg, MA 01420-1919
Phone (978) 878-8374

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171103001879 MA Practitioner - Family Practice 0749588655 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
269265MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Medical Care of Boston Management Corporation CurrentSince Oct 4, 2017 Accepting new patients

Locations

110 Long Pond Rd
Ste 101
Plymouth, MA 02360
Phone (508) 210-5850

46 Obery St
Plymouth, MA 02360
Phone (508) 210-5920

93 Pond St
Sharon, MA 02067
Phone (781) 784-9212

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1023457355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 LONG POND RD STE 101",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LONG POND RD STE 101",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602642",
            "telephone_number": "508-210-5850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "275 Nichols Rd",
            "address_purpose": "LOCATION",
            "city": "Fitchburg",
            "state": "MA",
            "postal_code": "014201919",
            "country_code": "US",
            "telephone_number": "978-878-8374",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DORVIL",
        "first_name": "CASSANDRA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-20",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "269265",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.