Active NPI
Michael J.F. Iannessa, M.D.
- Addiction Medicine (Internal Medicine) Physician
- Plymouth, MA
National Provider Identifier
1083633580
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction Medicine (Internal Medicine) Physician
- License
- 52862
- Practice address
- 1233 State Rd
Plymouth, MA 02360-5133 - Phone
- (508) 224-7701
- NPI assigned
- Jul 18, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction Medicine (Internal Medicine) Physician | 207RA0401X | 52862 | MA | Primary |
| Obstetrics & Gynecology Physician | 207V00000X | 52862 | MA |
Addresses
Primary practice location
1233 State Rd
Plymouth, MA 02360-5133
Mailing address
40 Chestnut St
Apt. #2
Charlestown, MA 02129-3436
Phone (781) 254-1148
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3136248 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52862 | MA | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| High Point Treatment Center Inc. | Past | Accepting new patients | |
| Compass Medical PC | Past | Accepting new patients |
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.
-
- Family Medicine Physician
- So Weymouth, MA
- NPI 1356462964
-
- Counselor
- New Bedford, MA
- NPI 1518996354
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153180800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338422400000",
"number": "1083633580",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "40 CHESTNUT ST",
"address_2": "APT. #2",
"city": "CHARLESTOWN",
"state": "MA",
"postal_code": "021293436",
"telephone_number": "781-254-1148"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1233 STATE RD",
"city": "PLYMOUTH",
"state": "MA",
"postal_code": "023605133",
"telephone_number": "508-224-7701"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IANNESSA",
"first_name": "MICHAEL",
"middle_name": "J.F.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-18",
"last_updated": "2012-05-31",
"status": "A"
},
"taxonomies": [
{
"code": "207RA0401X",
"taxonomy_group": "",
"desc": "Internal Medicine, Addiction Medicine",
"state": "MA",
"license": "52862",
"primary": true
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "MA",
"license": "52862",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3136248",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.