Michael Bader, MD
Individual provider Active NPI Internal Medicine Physician · Stoneham, MA
NPI 1184689804 · NPPES record last updated Apr 8, 2011
Key facts
- NPI
- 1184689804
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 52061 (MA)
- Practice address
- 92 Montvale Ave
Suite 3700
Stoneham, MA 02180-3644 - Phone
- (781) 438-5543
- Fax
- (781) 438-2001
- NPI assigned
- Apr 18, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52061 | MA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mass General Brigham Community Physicians Inc | Current |
Accepting new patients | |
| Stoneham Medical Group LLC | Internal Medicine | Past | Accepting new patients |
| Mystic Cardiology Associates Inc | Past |
Accepting new patients | |
| Michael Bader MD PC | Internal Medicine | Past | Accepting new patients |
Locations
170 Governors Ave
Medford, MA 02155
Phone (781) 306-6000
92 Montvale Ave
Ste 3400
Stoneham, MA 02180
Phone (781) 438-5543
Interoperability endpoints
- michael.bader.1@6568.direct.athenahealth.com
- bader.michael@elincdirect.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 52061 | MA | Yes |
Addresses
Primary practice location
92 Montvale Ave
Suite 3700
Stoneham, MA 02180-3644
Mailing address
92 Montvale Ave
Suite 3700
Stoneham, MA 02180-3647
Phone (781) 438-5543
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6175147 | Medicaid | MA |
Other providers in Stoneham, MA
- Arthur Tong, MD
- Atlantic Chiropractic Inc.
- Bernard J Augot, Jr.
- Farid Awad
- Nisrine Awad
- Nora Baghdad
- Tomer Bahar
- Audra L Bake
- Sangeeta Banerjee
- Kathleen Bannon
All providers in Stoneham, MA · Internal Medicine Physician in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.