NPIMap

Individual provider Active NPI

Christine Rita Medora, MD

  • Internal Medicine Physician
  • Hanover, NH
National Provider Identifier
1093827446
Registry record updated Jun 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
12968 Issued in NH
Practice address
45 Lyme Rd
Suite 104
Hanover, NH 03755-1219
Phone
(603) 643-3320
Fax
(603) 643-3301
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2021

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 12968 NH Primary

Addresses

Primary practice location

45 Lyme Rd
Suite 104
Hanover, NH 03755-1219

Mailing address

45 Lyme Rd Ste 104
Hanover, NH 03755-1220
Phone (603) 643-3320

Other identifiers 2

IdentifierTypeStateIssuer
30205501MedicaidNH
1011969MedicaidVT

Other names 1

  • Dr. Christine Rita Medora Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20051021000837 NH Practitioner - General PracticePractitioner - Internal Medicine 7911923560 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Tulane University School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hanover Continuity Clinic, PLLCGroup PAC ID 1759487481, 2 clinicians

Practice addresses (Care Compare)

45 Lyme Rd
Hanover, NH 03755-1220
Phone (603) 643-3320

Hospital & facility affiliations

  • Vna and Hospice of Vermont and New Hampshire Home health agency, White River Junction, VT, CCN 477002
  • Bayada Home Health Care, Inc. Home health agency, Rutland, VT, CCN 477019
  • Mary Hitchcock Memorial Hospital Hospital, Lebanon, NH, CCN 300003
  • Alice Peck Day Memorial Hospital Hospital, Lebanon, NH, CCN 301305
  • Gifford Medical Center Hospital, Randolph, VT, CCN 471301
  • New London Hospital Hospital, New London, NH, CCN 301304
  • Mt Ascutney Hospital Hospital, Windsor, VT, CCN 471302

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/DGJCAA/Endpoint/DGJCAA

Organizations & group practices 1

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.

Hospital & facility affiliations 19

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1093827446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 LYME RD STE 104",
            "city": "HANOVER",
            "state": "NH",
            "postal_code": "037551220",
            "telephone_number": "603-643-3320",
            "fax_number": "603-650-0916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 LYME RD",
            "address_2": "SUITE 104",
            "city": "HANOVER",
            "state": "NH",
            "postal_code": "037551219",
            "telephone_number": "603-643-3320",
            "fax_number": "603-643-3301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDORA",
        "first_name": "CHRISTINE",
        "middle_name": "RITA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NH",
            "license": "12968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30205501",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1011969",
            "state": "VT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "MEDORA",
            "middle_name": "RITA",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Hanover, NH

Sources for this page

Verify at the official NPI Registry.