NPIMap

Individual provider Active NPI

Nikolaos Michalacos, MD

  • Internal Medicine Physician
  • Whitman, MA
National Provider Identifier
1083697932
Registry record updated Aug 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
157162 Issued in MA
Practice address
312 Bedford St
Whitman, MA 02382-1859
Phone
(781) 792-6000
Fax
(781) 792-6165
NPI assigned
Nov 23, 2005
Last updated
Aug 25, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2011

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 157162 MA Primary

Addresses

Primary practice location

312 Bedford St
Whitman, MA 02382-1859

Mailing address

312 Bedford St
Whitman, MA 02382-1859
Phone (781) 792-6000

Other identifiers 1

IdentifierTypeStateIssuer
3182673MedicaidMA

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
I20080724000253 MA Practitioner - Internal Medicine 2860565850 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Boston University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Revere Medical of Massachusetts PCGroup PAC ID 0749715795, 113 clinicians
BMC Affiliated Physicians, Inc.Group PAC ID 9830133123, 543 clinicians
Steward Medical Group IncGroup PAC ID 2860688728, 23 clinicians

Practice addresses (Care Compare)

15 Roche Brothers Way
110 Revere Medical Easton Cardiology
North Easton, MA 02356-1000
Phone (781) 792-6500

235 N Pearl St
Brockton, MA 02301-1794
Phone (508) 427-3000

736 Cambridge St SMC
8 St Eliz Med Center
Brighton, MA 02135-2907
Phone (617) 789-5004

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
157162MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
BMC Affiliated Physicians, Inc. Internal Medicine CurrentSince Jan 1, 2026 Accepting new patients
Steward Medical Group, Inc CurrentSince Dec 1, 2011 Accepting new patients
Steward Medical Group, Inc CurrentSince Dec 1, 2011 Accepting new patients
Revere Medical of Massachusetts, PC Internal Medicine CurrentSince Oct 30, 2024 Accepting new patients

Locations

736 Cambridge St
#8
Brighton, MA 02135
Phone (617) 789-2375

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

1 Pearl St
Brockton, MA 02301
Phone (508) 586-3600

235 N Pearl St
Brockton, MA 02301
Phone (508) 427-2525

1 Pearl St
Ste 1000
Brockton, MA 02301
Phone (508) 897-6050

2100 Dorchester Ave
Dorchestr Ctr, MA 02124
Phone (617) 506-2222

15 Payson Rd
Ste 3
Foxboro, MA 02035
Phone (508) 772-1438

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

15 Roche Brothers Way
Ste 110
North Easton, MA 02356
Phone (781) 792-6500

9 Galen St
Watertown, MA 02472
Phone (617) 562-5413

312 Bedford St
Whitman, MA 02382
Phone (781) 447-8700

Interoperability endpoints

  • Direct secure messaging: nikolas.michalacos.1@32866.direct.athenahealth.com

Organizations & group practices 4

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 11

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": "1132704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314230400000",
    "number": "1083697932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "312 BEDFORD ST",
            "city": "WHITMAN",
            "state": "MA",
            "postal_code": "023821859",
            "telephone_number": "781-792-6000",
            "fax_number": "781-792-6165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 BEDFORD ST",
            "city": "WHITMAN",
            "state": "MA",
            "postal_code": "023821859",
            "telephone_number": "781-792-6000",
            "fax_number": "781-792-6165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHALACOS",
        "first_name": "NIKOLAOS",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-23",
        "last_updated": "2011-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "157162",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3182673",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitman, MA

Sources for this page

Verify at the official NPI Registry.