Individual provider Active NPI

Melissa Gleckel, M.D.

  • Family Medicine Physician
  • Worcester, MA
National Provider Identifier
1194145037
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
273549 Issued in MA
Practice address
19 Tacoma St
Worcester, MA 01605-3516
Phone
(508) 852-1805
NPI assigned
Apr 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 273549 MA Primary
Family Medicine Physician 207Q00000X MD17346 RI

Addresses

Primary practice location

19 Tacoma St
Worcester, MA 01605-3516

Mailing address

19 Tacoma St
Worcester, MA 01605-3516
Phone (508) 852-1805

Other practice location 1

101 Dudley St
Providence, RI 02905-2401
Phone (401) 729-2238

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mgleckel@wih.cernerdirect.carene.org Health Information Exchange (HIE)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, RI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180212001302 MA Practitioner - Family Practice 6709002082 Reassigns benefits to 1 organization
I20201124002148 RI Practitioner - Family Practice 6709002082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Edward M Kennedy Community Health Center IncGroup PAC ID 3476512740, shared by 5 NPIs, 65 clinicians

Practice addresses (Care Compare)

19 Tacoma St
Worcester, MA 01605-3516
Phone (508) 852-1805

Hospital & facility affiliations

  • Umass Memorial Medical Center/University Campus Hospital, Worcester, MA, CCN 220163

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
273549MAMDFamily Medicine Physician
MD17346RIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Affinity Physicians LLC CurrentSince Jan 1, 2021 Accepting new patients
Affinity Physicians LLC. Family Medicine CurrentSince Jan 1, 2021 Accepting new patients
Edward M. Kennedy Community Health Center, Inc CurrentSince Aug 1, 2022 Accepting new patients
Edward M. Kennedy Community Health Center, Inc CurrentSince Aug 1, 2022 Accepting new patients
Edward M. Kennedy Community Health Center, Inc Past Accepting new patients
Edward M. Kennedy Community Health Center, Inc Past Accepting new patients
Umass Memorial Medical Center, Inc. Past Accepting new patients

Locations

354 Waverley St
Framingham, MA 01702
Phone (508) 270-5700

41 Cape Rd
Milford, MA 01757
Phone (508) 270-5750

605 Lincoln St
Worcester, MA 01605
Phone (508) 856-0104

115 NE Cutoff
Bldg 2
Worcester, MA 01606
Phone (508) 854-2122

19 Tacoma St
Worcester, MA 01605
Phone (508) 854-2122

650 Lincoln St
Worcester, MA 01605
Phone (508) 532-7318

111 Brewster St
Pawtucket, RI 02860
Phone (401) 729-2000

101 Dudley St
Providence, RI 02905
Phone (401) 453-7950

455 Toll Gate Rd
Warwick, RI 02886
Phone (401) 737-7000

Interoperability endpoints

  • Direct secure messaging: mgleckel@direct.carene.org
  • Direct secure messaging: melissa.gleckel.p1@direct.emkchc.nextgenshare.com

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 1

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": "1397779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703635200000",
    "number": "1194145037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 TACOMA ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016053516",
            "telephone_number": "508-852-1805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19 TACOMA ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016053516",
            "telephone_number": "508-852-1805"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Dudley St",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029052401",
            "country_code": "US",
            "telephone_number": "401-729-2238",
            "fax_number": "401-729-2923",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GLECKEL",
        "first_name": "MELISSA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-18",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "273549",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "RI",
            "license": "MD17346",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mgleckel@wih.cernerdirect.carene.org",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "111 Brewster St",
            "city": "Pawtucket",
            "state": "RI",
            "country_code": "US",
            "postal_code": "028604400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.