NPIMap

Individual provider Active NPI

Gennady Gelman, M.D.

  • Family Medicine Physician
  • Sturbridge, MA
National Provider Identifier
1124453659
Registry record updated Jan 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
257429 Issued in MA
Practice address
198 Charlton Rd
Sturbridge, MA 01566
Phone
(508) 347-9240
Fax
(508) 347-5361
NPI assigned
Sep 3, 2013
Last updated
Jan 15, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME125545 FL
Family Medicine Physician 207Q00000X 036-140746 IL
Family Medicine Physician 207Q00000X 257429 MA Primary

Addresses

Primary practice location

198 Charlton Rd
Sturbridge, MA 01566

Mailing address

PO Box 40
Southbridge, MA 01550-0040
Phone (508) 909-7799

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20131206001394 MA Practitioner - Family Practice 9234366725 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

78 Sutton Ave
Oxford, MA 01540-1813
Phone (508) 499-1760

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036-140746ILMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group Inc Family Medicine Current Accepting new patients
Umass Memorial Health-Harrington Hospital Inc CurrentSince Mar 1, 2019 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Oct 1, 2023 Accepting new patients

Locations

10 N Main St
Charlton, MA 01507
Phone (508) 248-3015

78 Sutton Ave
Oxford, MA 01540
Phone (508) 499-1760

100 South St
Southbridge, MA 01550
Phone (508) 764-8012

100 South St
Ste 102
Southbridge, MA 01550
Phone (508) 765-7860

100 South St
Ste 208
Southbridge, MA 01550
Phone (508) 764-6356

164 South St
Southbridge, MA 01550
Phone (508) 755-4861

198 Charlton Rd
Sturbridge, MA 01566
Phone (508) 347-7585

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Interoperability endpoints

  • Direct secure messaging: gennadygelman@hps.allscriptsdirect.net

Organizations & group practices 3

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 8

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": "1378166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547510400000",
    "number": "1124453659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "015500040",
            "telephone_number": "508-909-7799",
            "fax_number": "508-764-2432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 CHARLTON RD",
            "city": "STURBRIDGE",
            "state": "MA",
            "postal_code": "01566",
            "telephone_number": "508-347-9240",
            "fax_number": "508-347-5361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GELMAN",
        "first_name": "GENNADY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-03",
        "last_updated": "2019-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME125545",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036-140746",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "257429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sturbridge, MA

Sources for this page

Verify at the official NPI Registry.