NPIMap

Organization Active NPI

Congenial Healthcare, LLC

Doing business as Family Medicine North

  • Adult Medicine Physician
  • Peabody, MA
National Provider Identifier
1124539382
Registry record updated Oct 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
Legal business name
CONGENIAL HEALTHCARE, LLC
Doing business as
Family Medicine North
Practice address
1 Roosevelt Ave Ste 201
Peabody, MA 01960-2227
Phone
(978) 536-0215
NPI assigned
Oct 16, 2017
Last updated
Oct 16, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
CONGENIAL HEALTHCARE, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 16, 2017

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

Authorized official

Name
Dr. Alain Chaoui, MDNPI 1023064789
Title
Physician
Phone
(978) 536-0215

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QA0505X Primary

Addresses

Primary practice location

1 Roosevelt Ave Ste 201
Peabody, MA 01960-2227

Mailing address

1 Roosevelt Ave Ste 201
Peabody, MA 01960-2227
Phone (978) 536-0215

Other names 1

  • Family Medicine North Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171016002508 MA Part B Supplier - Clinic/Group Practice 5395011522 Receives reassigned benefits from 18 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wakefield, MA; Lynnfield, MA; Peabody, MA; Lynn, MA

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Congenial Healthcare LLC7 organizations share this tax ID, including this one
Part of
Congenial Healthcare LLC

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1508112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508112000000",
    "number": "1124539382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ROOSEVELT AVE STE 201",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602227",
            "telephone_number": "978-536-0215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ROOSEVELT AVE STE 201",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602227",
            "telephone_number": "978-536-0215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONGENIAL HEALTHCARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CONGENIAL HEALTHCARE, LLC",
        "enumeration_date": "2017-10-16",
        "last_updated": "2017-10-16",
        "status": "A",
        "authorized_official_last_name": "CHAOUI",
        "authorized_official_first_name": "ALAIN",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "978-536-0215",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Medicine North",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peabody, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.