Individual provider Active NPI

Michelle Dorrell, M.D.

  • Pediatrics Physician
  • Cambridge, MA
National Provider Identifier
1053358093
Registry record updated May 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
226633 Issued in MA
Practice address
75 Mount Auburn St
Harvard University Health Services, Dept of Pediatrics
Cambridge, MA 02138-4960
Phone
(617) 495-4171
NPI assigned
May 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 226633 MA Primary

Addresses

Primary practice location

75 Mount Auburn St
Harvard University Health Services, Dept of Pediatrics
Cambridge, MA 02138-4960

Mailing address

75 Mount Auburn St
Harvard University Health Services, Dept of Pediatrics
Cambridge, MA 02138-4960
Phone (617) 495-4171

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
I20051117000626 MA Practitioner - Pediatric Medicine 7911926092 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
226633MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Medical Group, Inc Pediatrics CurrentSince Jan 21, 2019 Accepting new patients
Pratt Pediatric Associates Inc Pediatrics CurrentSince Dec 26, 2016 Accepting new patients

Locations

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

275 Sandwich St
Plymouth, MA 02360
Phone (508) 746-2000

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

366 Shrewsbury St
Worcester, MA 01604
Phone (508) 595-2700

Interoperability endpoints

  • Direct secure messaging: michelle.dorrell.npi1053358093.reliant@direct.optumcare.masshiway.net

Organizations & group practices 2

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": "1149033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306281600000",
    "number": "1053358093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 MOUNT AUBURN ST",
            "address_2": "HARVARD UNIVERSITY HEALTH SERVICES, DEPT OF PEDIATRICS",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384960",
            "telephone_number": "617-495-4171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 MOUNT AUBURN ST",
            "address_2": "HARVARD UNIVERSITY HEALTH SERVICES, DEPT OF PEDIATRICS",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384960",
            "telephone_number": "617-495-4171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORRELL",
        "first_name": "MICHELLE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-31",
        "last_updated": "2011-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "226633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.