Individual provider Active NPI

Teresa R Corcoran, MD

  • Internal Medicine Physician
  • Harwich Port, MA
National Provider Identifier
1093880411
Registry record updated Dec 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
77702 Issued in MA
Practice address
710 Main St
Harwich Port, MA 02646-1931
Phone
(508) 432-1400
Fax
(508) 430-2333
NPI assigned
Nov 21, 2006
Last updated
Dec 31, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 77702 MA Primary
Pediatrics Physician 208000000X 77702 MA

Addresses

Primary practice location

710 Main St
Harwich Port, MA 02646-1931

Mailing address

PO Box 598
Harwich Port, MA 02646-0598
Phone (508) 905-2800

Other identifiers 2

IdentifierTypeStateIssuer
3117791MedicaidMA
J14240OtherMABCBS MA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050616000987 MA Practitioner - Internal MedicinePractitioner - Pediatric Medicine 6305880642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
University of Massachusetts Medical School, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Outer Cape Health Services IncGroup PAC ID 4385554971, 51 clinicians

Practice addresses (Care Compare)

710 Route 28
Harwich Port, MA 02646-1931
Phone (508) 432-1400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Outer Cape Health Services, Inc. CurrentSince Jul 1, 2016 Accepting new patients
Outer Cape Health Services CurrentSince Jul 1, 2016 Accepting new patients
Outer Cape Health Services, Inc. Current Accepting new patients
Outer Cape Health Services Past Accepting new patients

Locations

49 Harry Kemp Way
Provincetown, MA 02657
Phone (508) 487-9395

Interoperability endpoints

  • Direct secure messaging: tcorcoran367770@direct.ochin.org

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 2

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546214400000",
    "number": "1093880411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 598",
            "city": "HARWICH PORT",
            "state": "MA",
            "postal_code": "026460598",
            "telephone_number": "508-905-2800",
            "fax_number": "508-240-1244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 MAIN ST",
            "city": "HARWICH PORT",
            "state": "MA",
            "postal_code": "026461931",
            "telephone_number": "508-432-1400",
            "fax_number": "508-430-2333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORCORAN",
        "first_name": "TERESA",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2018-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "77702",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "77702",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3117791",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "J14240",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Harwich Port, MA

Sources for this page

Verify at the official NPI Registry.