NPIMap

Individual provider Active NPI

Marc Emmerich, M.D.

  • Internal Medicine Physician
  • Boston, MA
National Provider Identifier
1033292636
Registry record updated Oct 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
59320 Issued in MA
Practice address
30 Northampton Street
Boston, MA 02118-4010
Phone
(617) 433-9601
Fax
(617) 445-6538
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 59320 MA Primary

Addresses

Primary practice location

30 Northampton Street
Boston, MA 02118-4010

Mailing address

30 Northampton Street
Boston, MA 02118-4010
Phone (617) 433-9601

Other identifiers 3

IdentifierTypeStateIssuer
3082865MedicaidMA
AA19012OtherMAHARVARD PILGRIM NUMBER
J10694OtherMIBCBS NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050119000935 MA Practitioner - Internal Medicine 1456300177 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bostons Community Medical Group IncGroup PAC ID 1355390691, 31 clinicians

Practice addresses (Care Compare)

30 Northampton St
Boston, MA 02118-4098
Phone (617) 433-9601

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
59320MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Commonwealth Clinical Alliance, Inc CurrentSince Feb 1, 2026 Accepting new patients
Boston Medical Center Corporation Current Accepting new patients
Boston'S Community Medical Group, Inc. CurrentSince Oct 1, 2004 Accepting new patients
Liberty Health Care Corporation Internal Medicine Past Accepting new patients

Locations

1 Boston Medical Ctr Pl
Roxbury, MA 02118
Phone (617) 414-5245

30 Northampton St
Roxbury, MA 02118
Phone (617) 433-9601

3550 Main St
Ste 101
Springfield, MA 01107
Phone (413) 739-0669

Interoperability endpoints

  • Direct secure messaging: memmerich10179@direct.bmc.masshiway.net
  • Direct secure messaging: marc.emmerich@ccalliance.eclinicaldirectplus.com

Organizations & group practices 4

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1445472000000",
    "number": "1033292636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 NORTHAMPTON STREET",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021184010",
            "telephone_number": "617-433-9601",
            "fax_number": "617-445-6538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 NORTHAMPTON STREET",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021184010",
            "telephone_number": "617-433-9601",
            "fax_number": "617-445-6538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EMMERICH",
        "first_name": "MARC",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2015-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "59320",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3082865",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM NUMBER",
            "identifier": "AA19012",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS NUMBER",
            "identifier": "J10694",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.