Individual provider Active NPI

Michael W Tremblay, D.O.

  • Family Medicine Physician
  • Holbrook, MA
National Provider Identifier
1093761793
Registry record updated Mar 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
71932 Issued in MA
Practice address
175 N Franklin St
Holbrook, MA 02343-1171
Phone
(781) 767-0910
Fax
(781) 767-9019
NPI assigned
May 25, 2006
Last updated
Mar 7, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 71932 MA Primary

Addresses

Primary practice location

175 N Franklin St
Holbrook, MA 02343-1171

Mailing address

175 N Franklin St
Holbrook, MA 02343-1171
Phone (781) 767-0910

Other identifiers 3

IdentifierTypeStateIssuer
717264OtherMATAHP
3056651MedicaidMA
7865OtherMAHPHC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Yes, effective Oct 1, 2017 through Oct 1, 2027

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
71932MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Medical PC Family Medicine 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1362614400000",
    "number": "1093761793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 N FRANKLIN ST",
            "city": "HOLBROOK",
            "state": "MA",
            "postal_code": "023431171",
            "telephone_number": "781-767-0910",
            "fax_number": "781-767-9019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 N FRANKLIN ST",
            "city": "HOLBROOK",
            "state": "MA",
            "postal_code": "023431171",
            "telephone_number": "781-767-0910",
            "fax_number": "781-767-9019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREMBLAY",
        "first_name": "MICHAEL",
        "middle_name": "W",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2013-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "71932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAHP",
            "identifier": "717264",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3056651",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "7865",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holbrook, MA

Sources for this page

Verify at the official NPI Registry.