Individual provider Active NPI

Pantea Ebrahimpour, M.D.

  • Endocrinology, Diabetes & Metabolism Physician
  • Worcester, MA
National Provider Identifier
1205389715
Registry record updated Feb 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
281401 Issued in MA
Practice address
55 Lake Ave N
Worcester, MA 01655-0002
Phone
(508) 334-3206
Fax
(774) 442-4668
NPI assigned
Aug 1, 2016
Last updated
Feb 2, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 281401 MA Primary

Addresses

Primary practice location

55 Lake Ave N
Worcester, MA 01655-0002

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (885) 225-8885

Other practice location 1

1 Eaton Pl Fl 3
Worcester, MA 01608-1232
Phone (508) 425-5880

Other practice location 2

281 Hartford Ave E
Uxbridge, MA 01569-1278
Phone (508) 334-3206

Other identifiers 1

IdentifierTypeStateIssuer
110132156AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20191014002940 MA Practitioner - Internal MedicinePractitioner - Endocrinology 7618208166 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Endocrinology
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

5 Neponset St
Worcesteer, MA 01606-2714
Phone (508) 595-2300

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
281401MAMDEndocrinology, Diabetes & Metabolism Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Medical Group, Inc Internal Medicine CurrentSince Jul 31, 2023 Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients

Locations

24 Newton St
Southborough, MA 01772
Phone (508) 460-3190

1 Eaton Pl
Fl 3
Worcester, MA 01608
Phone (508) 425-5880

123 Summer St
Worcester, MA 01608
Phone (508) 363-6000

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

5 Neponset St
Fl 12
Worcester, MA 01606
Phone (508) 852-6175

Interoperability endpoints

  • Direct secure messaging: pantea.ebrahimpour.1@19711.direct.athenahealth.com
  • Direct secure messaging: pantea.ebrahimpour.npi1205389715.reliant@direct.optumcare.masshiway.net
  • Direct secure messaging: pebrahimpour796571@direct.hfhs.org

Organizations & group practices 3

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 3

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": "1470009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769990400000",
    "number": "1205389715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "885-225-8885",
            "fax_number": "508-334-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-334-3206",
            "fax_number": "774-442-4668"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Eaton Pl Fl 3",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016081232",
            "country_code": "US",
            "telephone_number": "508-425-5880",
            "fax_number": "508-595-2122",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "281 Hartford Ave E",
            "address_purpose": "LOCATION",
            "city": "Uxbridge",
            "state": "MA",
            "postal_code": "015691278",
            "country_code": "US",
            "telephone_number": "508-334-3206",
            "fax_number": "774-442-4668",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EBRAHIMPOUR",
        "first_name": "PANTEA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-01",
        "last_updated": "2026-02-02",
        "certification_date": "2026-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "MA",
            "license": "281401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110132156A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.