NPIMap

Individual provider Active NPI

Tina Waugh, MD

  • Family Medicine Physician
  • Beverly, MA
National Provider Identifier
1174510382
Registry record updated May 11, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
158505 Issued in MA
Practice address
38R Enon St
Beverly, MA 01915-1166
Phone
(978) 927-7727
Fax
(978) 927-4598
NPI assigned
Oct 3, 2005
Last updated
May 11, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 11, 2009

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 158505 MA Primary

Addresses

Primary practice location

38R Enon St
Beverly, MA 01915-1166

Mailing address

38R Enon St
Beverly, MA 01915-1166
Phone (978) 927-7727

Other identifiers 1

IdentifierTypeStateIssuer
0105953MedicaidMA

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
I20050608000275 MA Practitioner - Family Practice 6709777428 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Boston University School of Medicine, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Care Dimensions IncGroup PAC ID 7214924554, 16 clinicians

Practice addresses (Care Compare)

15 Railroad Ave
South Hamilton, MA 01982-2218
Phone (978) 468-7381

75 Sylvan St
Suite B102
Danvers, MA 01923-2764
Phone (978) 774-7566

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
158505MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Lahey Health Specialty Care, Inc. CurrentSince Feb 19, 2013 Accepting new patients
Care Dimensions, Inc. CurrentSince Nov 19, 2022 Accepting new patients
Family Medicine Associates P. C. CurrentSince Mar 23, 2004 Accepting new patients
Beth Israel Lahey Health Primary Care, Inc. Family Medicine CurrentSince Nov 1, 2024 Accepting new patients
Care Dimensions, Inc. CurrentSince Nov 19, 2022 Accepting new patients
Beth Israel Lahey Health Primary Care Inc CurrentSince Nov 1, 2024 Accepting new patients
Beth Israel Lahey Health Primary Care, Inc. Past Accepting new patients

Locations

30 Tozer Rd
Ste 202
Beverly, MA 01915
Phone (978) 927-7727

38 Enon St
Beverly, MA 01915
Phone (978) 927-7727

38 Enon St
#R
Beverly, MA 01915
Phone (978) 927-7727

85 Herrick St
Beverly, MA 01915
Phone (978) 816-3700

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

75 Lindall St
Danvers, MA 01923
Phone (978) 767-2847

75 Sylvan St
Ste B102
Danvers, MA 01923
Phone (888) 283-1722

15 Railroad Ave
South Hamilton, MA 01982
Phone (978) 468-7381

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10729/brand/1/csg/1/fhir/r4
  • FHIR API: https://app.meldrx.com/api/fhir/caredimensions
  • Direct secure messaging: twaugh31560@direct.bilh.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 16

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1128297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242000000000",
    "number": "1174510382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38R ENON ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151166",
            "telephone_number": "978-927-7727",
            "fax_number": "978-927-4598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38R ENON ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151166",
            "telephone_number": "978-927-7727",
            "fax_number": "978-927-4598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAUGH",
        "first_name": "TINA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-03",
        "last_updated": "2009-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "158505",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0105953",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

Verify at the official NPI Registry.