Active NPI
Michael Terrence Myers Jr., MD, MBA
- Internal Medicine Physician
- Needham, MA
National Provider Identifier
1114045382
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 57242
- Practice address
- 115 Fourth Avenue
Needham, MA 02494-2725 - Phone
- (781) 433-3014
- Fax
- (781) 449-3776
- NPI assigned
- Mar 27, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 57242 | MA | Primary |
Addresses
Primary practice location
115 Fourth Avenue
Needham, MA 02494-2725
Mailing address
35 Channel Ctr St
Unit #402
Boston, MA 02210-3413
Phone (781) 433-3014
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
- Credentials
- Master of Business Administration, Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57242 | MA | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1114045382",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 CHANNEL CTR ST",
"address_2": "UNIT #402",
"city": "BOSTON",
"state": "MA",
"postal_code": "022103413",
"telephone_number": "781-433-3014",
"fax_number": "781-449-3776"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 FOURTH AVENUE",
"city": "NEEDHAM",
"state": "MA",
"postal_code": "024942725",
"telephone_number": "781-433-3014",
"fax_number": "781-449-3776"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MYERS",
"first_name": "MICHAEL",
"middle_name": "TERRENCE",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD, MBA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-27",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "57242",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Needham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.