NPIMap

Individual provider Active NPI

Glennon John Ogrady

  • Family Medicine Physician
  • Dorchester, MA
National Provider Identifier
1174502140
Registry record updated Mar 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
59292 Issued in MA
Practice address
2100 Dorchester Avenue
Family Medicine
Dorchester, MA 02124
Phone
(617) 506-4970
Fax
(978) 686-4137
NPI assigned
Jan 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 59292 MA Primary

Addresses

Primary practice location

2100 Dorchester Avenue
Family Medicine
Dorchester, MA 02124

Mailing address

2100 Dorchester Avenue
Family Medicine
Dorchester, MA 02124
Phone (617) 506-4970

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
I20041207000246 MA Practitioner - Family Practice 0042282378 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Tufts University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Internal Medical Associates-EbnhcGroup PAC ID 6103814371, 239 clinicians

Practice addresses (Care Compare)

10 Gove St
East Boston, MA 02128-1920
Phone (617) 569-5800

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
South Boston Community Health Center CurrentSince May 6, 2017 Accepting new patients
Steward Medical Group, Inc CurrentSince Dec 19, 2011 Accepting new patients
Medical Associates of Ebnhc Current Accepting new patients
Internal Medical Associates-Ebnhc CurrentSince Dec 1, 2019 Accepting new patients
Steward Medical Group, Inc CurrentSince Dec 19, 2011 Accepting new patients
Neighborhealth Corporation CurrentSince Dec 1, 2019 Accepting new patients
Community Medical Associates, Inc. Family Medicine Past Accepting new patients

Locations

1601 Washington St
Boston, MA 02118
Phone (617) 425-2000

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

2100 Dorchester Ave
Dorchestr Ctr, MA 02124
Phone (617) 506-2222

10 Grove St
East Boston, MA 02128
Phone (617) 569-5800

1 General St
Lawrence, MA 01841
Phone (978) 946-8103

409 W Broadway
South Boston, MA 02127
Phone (617) 269-7500

Interoperability endpoints

  • Direct secure messaging: gogrady28197@direct.neighborhealth.masshiway.net

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1136851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332460800000",
    "number": "1174502140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 DORCHESTER AVENUE",
            "address_2": "FAMILY MEDICINE",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "02124",
            "telephone_number": "617-506-4970",
            "fax_number": "978-686-4137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 DORCHESTER AVENUE",
            "address_2": "FAMILY MEDICINE",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "02124",
            "telephone_number": "617-506-4970",
            "fax_number": "978-686-4137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OGRADY",
        "first_name": "GLENNON",
        "middle_name": "JOHN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-10",
        "last_updated": "2012-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "59292",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dorchester, MA

Sources for this page

Verify at the official NPI Registry.