Individual provider Active NPI

Marguerite C. Roach, M.D.

  • Internal Medicine Physician
  • Concord, MA
National Provider Identifier
1124087853
Registry record updated Nov 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
59897 Issued in MA
Practice address
80 Beharrell St # 80a
Concord, MA 01742-1739
Phone
(781) 259-9292
Fax
(781) 259-0747
NPI assigned
Mar 21, 2006
Last updated
Nov 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2020

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 59897 MA Primary

Addresses

Primary practice location

80 Beharrell St # 80a
Concord, MA 01742-1739

Mailing address

80 Beharrell St # 80a
Concord, MA 01742-1739
Phone (781) 259-9292

Other identifiers 1

IdentifierTypeStateIssuer
3151387MedicaidMA

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
I20111216000630 MA Practitioner - Internal Medicine 7618993809 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
59897MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Community Physicians Inc. Internal Medicine CurrentSince Jan 9, 1989 Accepting new patients
Mass General Brigham Community Physicians Inc CurrentSince Jan 9, 1989 Accepting new patients

Locations

80 Beharrell St
Concord, MA 01742
Phone (781) 259-9292

80 Beharrell St
#80A
Concord, MA 01742
Phone (781) 259-9292

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": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606089600000",
    "number": "1124087853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 BEHARRELL ST # 80A",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017421739",
            "telephone_number": "781-259-9292",
            "fax_number": "781-259-0747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 BEHARRELL ST # 80A",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017421739",
            "telephone_number": "781-259-9292",
            "fax_number": "781-259-0747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROACH",
        "first_name": "MARGUERITE",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-21",
        "last_updated": "2020-11-23",
        "certification_date": "2020-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "59897",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3151387",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

Verify at the official NPI Registry.