Individual provider Active NPI

Michele F Greenwald, M.D.

  • Pediatrics Physician
  • Braintree, MA
National Provider Identifier
1124006754
Registry record updated Nov 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
81760 Issued in MA
Practice address
111 Grossman Dr
Braintree, MA 02184-4997
Phone
(781) 849-2300
Fax
(781) 849-2377
NPI assigned
Jan 4, 2006
Last updated
Nov 16, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 81760 MA Primary

Addresses

Primary practice location

111 Grossman Dr
Braintree, MA 02184-4997

Mailing address

111 Grossman Dr
Braintree, MA 02184-4997
Phone (781) 849-2300

Other identifiers 6

IdentifierTypeStateIssuer
0015204OtherMANEIGHBORHOOD HEALTH
PP859OtherMAHARVARD PILGRIM
081760OtherMATUFTS
3154751MedicaidMA
J17000OtherMABLUE CROSS
B10460202OtherMACIGNA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mgreenwaldmd9762@direct.atrius.masshiway.net

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
I20101119000429 MA Practitioner - Pediatric Medicine 7517153380 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. CurrentSince Sep 1, 2010 Accepting new patients
Atrius Health, Inc. CurrentSince Sep 1, 2010 Accepting new patients
Atrius Health, Inc. Pediatrics Current Accepting new patients
Atrius Health, Inc. Pediatrics Past Accepting new patients

Locations

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051

111 Grossman Dr
Braintree, MA 02184
Phone (781) 849-1000

Interoperability endpoints

  • Direct secure messaging: mgreenwaldmd9762@direct.atrius.masshiway.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1136332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1124006754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 GROSSMAN DR",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021844997",
            "telephone_number": "781-849-2300",
            "fax_number": "781-849-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 GROSSMAN DR",
            "city": "BRAINTREE",
            "state": "MA",
            "postal_code": "021844997",
            "telephone_number": "781-849-2300",
            "fax_number": "781-849-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREENWALD",
        "first_name": "MICHELE",
        "middle_name": "F",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-04",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "81760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH",
            "identifier": "0015204",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "PP859",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "081760",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3154751",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "J17000",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "B10460202",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgreenwaldmd9762@direct.atrius.masshiway.net",
            "affiliation": "N",
            "address_1": "111 Grossman Dr",
            "city": "Braintree",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021844997",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Braintree, MA

Sources for this page

Verify at the official NPI Registry.