NPIMap

Individual provider Active NPI

Magdy Sami Badereldin, MD AND PA

  • Medical Physician Assistant
  • Roxbury, MA
National Provider Identifier
1205034469
Registry record updated Apr 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA3743 Issued in MA
Practice address
59 Townsend St
Roxbury, MA 02119-1318
Phone
(617) 442-8760
NPI assigned
Jul 10, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA3743 MA Primary

Addresses

Primary practice location

59 Townsend St
Roxbury, MA 02119-1318

Mailing address

819 Worcester St
Suite 3
Springfield, MA 01151-1001
Phone (413) 543-6820

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
I20090602000662 MA Practitioner - Physician Assistant 2567512106 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Vibra Physicians LLCGroup PAC ID 8921233933, 30 clinicians
Athol Memorial Hospital IncorporatedGroup PAC ID 7911959846, 81 clinicians

Practice addresses (Care Compare)

111 Huntoon Memorial Hwy
Rochdale, MA 01542-1305
Phone (617) 899-5017

2033 Main St
Athol, MA 01331-3535
Phone (978) 249-3511

4499 Acushnet Ave
New Bedford, MA 02745-4707
Phone (508) 995-6900

Hospital & facility affiliations

  • Umass Memorial Medical Center/University Campus Hospital, Worcester, MA, CCN 220163
  • Heywood Hospital - Hospital, Gardner, MA, CCN 220095
  • Athol Memorial Hospital Hospital, Athol, MA, CCN 221303
  • Vibra Hospital of Western Mass - Central Campus Long-term care hospital, Rochdale, MA, CCN 222046
  • Athol Memorial Hospital Nursing home, CCN 22Z303

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA3743MAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Heywood Memorial Hospital CurrentSince Mar 13, 2024 Accepting new patients
Athol Memorial Hospital Incorporated CurrentSince Mar 13, 2024 Accepting new patients
Medical Director Services PC CurrentSince Sep 19, 2025 Accepting new patients
Ipc Hospitalists of New England PC CurrentSince May 21, 2009 Accepting new patients
Vibra Hospital of Western Massachusetts, LLC Past Accepting new patients
Henry Heywood Memorial Hospital Past Accepting new patients

Locations

2033 Main St
Athol, MA 01331
Phone (978) 249-1295

59 Eastwood Cir
Gardner, MA 01440
Phone (978) 632-5048

242 Green St
Ste 205
Gardner, MA 01440

242 Green St
Gardner, MA 01440
Phone (978) 258-4734

67 Union St
Natick, MA 01760
Phone (508) 383-1104

111 Huntoon Memorial Hwy
Rochdale, MA 01542
Phone (508) 892-4858

59 Townsend St
Roxbury, MA 02119
Phone (617) 442-8760

819 Worcester St
Ste 3
Springfield, MA 01151
Phone (413) 543-6820

Organizations & group practices 12

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 7

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": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240272000000",
    "number": "1205034469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 WORCESTER ST",
            "address_2": "SUITE 3",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011511001",
            "telephone_number": "413-543-6820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "59 TOWNSEND ST",
            "city": "ROXBURY",
            "state": "MA",
            "postal_code": "021191318",
            "telephone_number": "617-442-8760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADERELDIN",
        "first_name": "MAGDY",
        "middle_name": "SAMI",
        "name_prefix": "Dr.",
        "credential": "MD AND PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-10",
        "last_updated": "2009-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA3743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roxbury, MA

Sources for this page

Verify at the official NPI Registry.