NPIMap

Individual provider Active NPI

John M. Stevenson, M.D.

  • Internal Medicine Physician
  • Pembroke, MA
National Provider Identifier
1043284789
Registry record updated Feb 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
155843 Issued in MA
Practice address
15 Old West Elm St
Pembroke, MA 02359-1731
Phone
(781) 202-9292
Fax
(781) 202-9299
NPI assigned
Feb 16, 2006
Last updated
Feb 23, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 23, 2023

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 155843 MA Primary

Addresses

Primary practice location

15 Old West Elm St
Pembroke, MA 02359-1731

Mailing address

15 Old West Elm St
Pembroke, MA 02359-1731
Phone (781) 718-7435

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
I20060126000558 MA Practitioner - Internal Medicine 5991787210 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Massachusetts Medical School, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Shore Medical Center, Inc.Group PAC ID 3678487444, 174 clinicians
Pembroke Medical Associates IncGroup PAC ID 3678992955, 26 clinicians

Practice addresses (Care Compare)

143 Longwater Dr
Norwell, MA 02061-1683
Phone (781) 878-5200

15 Old W Elm St
Pembroke, MA 02359-1731
Phone (781) 202-9292

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Norwell Visiting Nurse Association Inc CurrentSince Oct 1, 2022 Accepting new patients
South Shore Medical Center, Inc. Internal Medicine CurrentSince Sep 11, 2017 Accepting new patients
Coastal Medical Associates CurrentSince Jan 1, 2007 Accepting new patients
Pai Participant Ma PC CurrentSince Nov 27, 2023 Accepting new patients
Norwell Visiting Nurse Association, Inc Past Accepting new patients
Senior Residential Care - Kingston, Inc. Past Accepting new patients
Bane Harbor House, LLC Past Accepting new patients
South Cove Manor Nursing and Rehabilitation Center, Inc. Past Accepting new patients
Bane John Scott, LLC Past Accepting new patients
Royal Norwell Nursing & Rehabilitation Center LLC Past Accepting new patients
140 Webb St., Inc. Past Accepting new patients
Alliance Health of Quincy, Inc. Past Accepting new patients
Bane Hancock Park, LLC Past Accepting new patients
Alliance Health of Quincy, Inc. Past Accepting new patients
South Shore Medical Investors, LLC Past Accepting new patients
Plymouth Medical Investors, LLC Past Accepting new patients
RC Quincy LLC Past Accepting new patients
Bane Bay Path, LLC Past Accepting new patients
Southwood at Norwell Nursing Center Past Accepting new patients
Braintree Rehabilitation Medical Associates, P.C. Internal Medicine PastSince Feb 9, 2006 Accepting new patients
Alliance Health of Southeastern Massachusetts, Inc. Past Accepting new patients
FS Patriot LLC Past Accepting new patients

Locations

111 Orient Ave
East Boston, MA 02128
Phone (617) 569-1200

5 Tarkiln Rd
Kingston, MA 02364
Phone (781) 585-2200

120 Longwater Dr
Norwell, MA 02061
Phone (781) 659-2342

120 Longwater Dr
Ste 200
Norwell, MA 02061
Phone (781) 659-2342

141 Longwater Dr
Ste 201
Norwell, MA 02061
Phone (781) 261-7820

143 Longwater Dr
Norwell, MA 02061
Phone (781) 792-4136

55 Fogg Rd
Weymouth, MA 02190
Phone (781) 340-4293

Ownership & related parties

All facility ownership & control disclosures 3

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Life Care Center of PlymouthPlymouth, MA, CCN 225666 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Feb 1, 2023
Mar 28, 2025
South Cove Manor at Quincy Point Rehabilitation CenterQuincy, MA, CCN 225514 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Mar 1, 2025
Mar 11, 2025
Life Care Center of the South ShoreScituate, MA, CCN 225282 Skilled nursing facility Operational/Managerial Control
Adp of the SNF		 Oct 1, 2023
Feb 28, 2025

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 23

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

View all 23

Hospital & facility affiliations 12

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": "1140048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1043284789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 OLD WEST ELM ST",
            "city": "PEMBROKE",
            "state": "MA",
            "postal_code": "023591731",
            "telephone_number": "781-718-7435"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 OLD WEST ELM ST",
            "city": "PEMBROKE",
            "state": "MA",
            "postal_code": "023591731",
            "telephone_number": "781-202-9292",
            "fax_number": "781-202-9299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENSON",
        "first_name": "JOHN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-16",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "155843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke, MA

Sources for this page

Verify at the official NPI Registry.