Individual provider Active NPI

Halward M Blegen III, MD

  • Internal Medicine Physician
  • Sagamore Beach, MA
National Provider Identifier
1134121502
Registry record updated Jul 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
49939 Issued in MA
Practice address
180 State Rd
Sagamore Beach, MA 02562-2362
Phone
(508) 888-7221
Fax
(508) 888-2062
NPI assigned
Aug 15, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2012

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 49939 MA Primary

Addresses

Primary practice location

180 State Rd
Sagamore Beach, MA 02562-2362

Mailing address

180 State Rd
PO Box 315
Sagamore Beach, MA 02562-2362
Phone (508) 888-7221

Other identifiers 1

IdentifierTypeStateIssuer
0175374MedicaidMA

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
I20051107001097 MA Practitioner - Internal Medicine 2466470547 Practice locations: Plymouth, MA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Albert Einstein College of Medicine of Yeshiva University, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

110 Long Pond Rd
Suite 205
Plymouth, MA 02360-2642
Phone (508) 888-7221

Hospital & facility affiliations

National Provider Directory

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

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HEFDBA/Endpoint/HEFDBA

Hospital & facility affiliations 3

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": "1124064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341187200000",
    "number": "1134121502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 STATE RD",
            "address_2": "PO BOX 315",
            "city": "SAGAMORE BEACH",
            "state": "MA",
            "postal_code": "025622362",
            "telephone_number": "508-888-7221",
            "fax_number": "508-888-2062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 STATE RD",
            "city": "SAGAMORE BEACH",
            "state": "MA",
            "postal_code": "025622362",
            "telephone_number": "508-888-7221",
            "fax_number": "508-888-2062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLEGEN",
        "first_name": "HALWARD",
        "middle_name": "M",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-15",
        "last_updated": "2012-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "49939",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0175374",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sagamore Beach, MA

Sources for this page

Verify at the official NPI Registry.