Individual provider Active NPI

Michael Light II, D.O.

  • Internal Medicine Physician
  • Plymouth, MA
National Provider Identifier
1063837292
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
282933 Issued in MA
Practice address
3 Village GRN N
Plymouth, MA 02360-8803
Phone
(508) 224-2224
NPI assigned
Feb 25, 2014
Last updated
Jul 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 0102204325 VA
Internal Medicine Physician 207R00000X 282933 MA Primary

Addresses

Primary practice location

3 Village GRN N
Plymouth, MA 02360-8803

Mailing address

3 Village GRN N
Plymouth, MA 02360-8803
Phone (508) 224-2224

Other practice location 1

620 Jhn Paul Jns Cir
Naval Medical Center Portsmouth
Portsmouth, VA 23708-2197
Phone (757) 953-3149

Other practice location 2

554 Keily Street
Jacksonville, FL 32212
Phone (757) 953-7550

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
I20200818003147 MA Practitioner - Internal Medicine 0749596302 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of New England, College of Osteo Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians

Practice addresses (Care Compare)

1 Lyons St
Dedham, MA 02026-5599
Phone (781) 329-1400

100 2ND Ave
Needham, MA 02494-2809
Phone (781) 726-4800

133 Brookline Ave
Boston, MA 02215-3904
Phone (617) 421-1000

2 Technology Park Dr
Suite a
Bourne, MA 02532-8341
Phone (508) 743-9543

20 Wall St
Burlington, MA 01803-4758
Phone (781) 221-2500

21 Bristol Dr
South Easton, MA 02375-1199
Phone (774) 302-5700

291 Independence Dr
Chestnut Hill, MA 02467-3628
Phone (617) 325-2800

36 Shops at 5 Way
Plymouth, MA 02360-2677
Phone (774) 608-3700

77 Herrick St
Suite 101
Beverly, MA 01915-2734
Phone (978) 927-4110

90 Libbey Industrial Pkwy
Suite 201
Weymouth, MA 02189-3157
Phone (781) 682-0606

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. Internal Medicine CurrentSince Aug 1, 2020 Accepting new patients
Atrius Health, Inc. Internal Medicine CurrentSince Aug 1, 2020 Accepting new patients

Locations

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051

Interoperability endpoints

  • Direct secure messaging: mlightdo322337@direct.atrius.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

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": "1393286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1063837292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 VILLAGE GRN N",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023608803",
            "telephone_number": "508-224-2224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 VILLAGE GRN N",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023608803",
            "telephone_number": "508-224-2224"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "620 Jhn Paul Jns Cir",
            "address_2": "Naval Medical Center Portsmouth",
            "address_purpose": "LOCATION",
            "city": "Portsmouth",
            "state": "VA",
            "postal_code": "237082197",
            "country_code": "US",
            "telephone_number": "757-953-3149",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "554 Keily Street",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "32212",
            "country_code": "US",
            "telephone_number": "757-953-7550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIGHT",
        "first_name": "MICHAEL",
        "name_suffix": "II",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-02-25",
        "last_updated": "2022-07-21",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "VA",
            "license": "0102204325",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "282933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.