Congenial Healthcare, LLC
Organization Active NPI Family Medicine Physician · Middleton, MA
NPI 1063923399 · NPPES record last updated Oct 13, 2017
Key facts
- NPI
- 1063923399
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- CONGENIAL HEALTHCARE, LLC
- Practice address
- 147 S Main St
Middleton, MA 01949-2446 - Phone
- (978) 774-2555
- NPI assigned
- Oct 13, 2017
- Organization subpart
- Yes
- Parent organization (as reported)
- CONGENIAL HEALTHCARE, LLC
Authorized official
- Name
- Dr. Mark Allara, MD
- Title
- Partner
- Phone
- (978) 774-2555
Other NPIs on the same Medicare enrollment 8
Practitioners 16
-
Suzanne Baughn, NP
-
David W Douglas, MD
-
Bhagwan Dass Gupta, MD FACC
-
Gabrielle Murray, DNP, APRN
-
Keith William Rae, D.M.D., M.D.
-
Prathima Vemuru Reddy, M.D.
-
Jill Michelle Roffman Levine, LICSW
-
Lojine Kamel, MD
-
Jelena Kupcevic, FNP-BC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20171016002508 | MA | Part B Supplier - Clinic/Group Practice | 5395011522 |
Receives reassigned benefits from 18 practitioners 8 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Wakefield, MA; Lynnfield, MA; Peabody, MA; Lynn, MA |
National Provider Directory
- Part of
- Congenial Healthcare LLC
Locations
1 Walton St
Wakefield, MA 01880
Phone (781) 246-9113
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Adult Medicine Physician |
207QA0505X |
Addresses
Primary practice location
147 S Main St
Middleton, MA 01949-2446
Mailing address
147 S Main St
Middleton, MA 01949-2446
Phone (978) 774-2555
Other names
- Middleton Family Medicine Associates
NPI Registry JSON
{
"created_epoch": "1507852800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1507852800000",
"number": "1063923399",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147 S MAIN ST",
"city": "MIDDLETON",
"state": "MA",
"postal_code": "019492446",
"telephone_number": "978-774-2555"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "147 S MAIN ST",
"city": "MIDDLETON",
"state": "MA",
"postal_code": "019492446",
"telephone_number": "978-774-2555"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CONGENIAL HEALTHCARE, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "CONGENIAL HEALTHCARE, LLC",
"enumeration_date": "2017-10-13",
"last_updated": "2017-10-13",
"status": "A",
"authorized_official_last_name": "ALLARA",
"authorized_official_first_name": "MARK",
"authorized_official_title_or_position": "PARTNER",
"authorized_official_telephone_number": "978-774-2555",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207QA0505X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Family Medicine, Adult Medicine",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Middleton Family Medicine Associates",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Middleton, MA
- Jason Chandler
- Tamar Gayane Changelian
- Jason Chao
- Choice Cardiovascular Group, LLC
- Christina Morris, Inc.
- Congenial Healthcare, LLC
- Colleen Marie Cormier
- Corrections - Comprehensive Treatment Centers, LLC
- CVS Pharmacy Inc
- Katherine Davis
All providers in Middleton, MA · Family Medicine Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 13, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.