Active NPI
Michael D Palys, DMD
- Periodontics
- Cambridge, MA
National Provider Identifier
1194808683
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 18523
- Practice address
- 75 Mount Auburn St
Floor 1
Cambridge, MA 02138-4960 - Phone
- (617) 495-2063
- Fax
- (617) 495-0562
- NPI assigned
- Oct 20, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 18523 | MA | Primary |
Addresses
Primary practice location
75 Mount Auburn St
Floor 1
Cambridge, MA 02138-4960
Mailing address
75 Mount Auburn St
Floor 1
Cambridge, MA 02138-4960
Phone (617) 495-2063
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18523 | MA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161302400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1194808683",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "75 MOUNT AUBURN ST",
"address_2": "FLOOR 1",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021384960",
"telephone_number": "617-495-2063",
"fax_number": "617-495-0562"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 MOUNT AUBURN ST",
"address_2": "FLOOR 1",
"city": "CAMBRIDGE",
"state": "MA",
"postal_code": "021384960",
"telephone_number": "617-495-2063",
"fax_number": "617-495-0562"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALYS",
"first_name": "MICHAEL",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "MA",
"license": "18523",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cambridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.