Individual provider Active NPI

Michelle L. Travassos, MD

  • Pediatrics Physician
  • Acton, MA
National Provider Identifier
1205825577
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
213482 Issued in MA
Practice address
321 Main St
Acton, MA 01720-3718
Phone
(978) 263-0680
Fax
(978) 263-4880
NPI assigned
Oct 19, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 213482 MA Primary

Addresses

Primary practice location

321 Main St
Acton, MA 01720-3718

Mailing address

321 Main St
Acton, MA 01720-3718
Phone (978) 263-0680

Other identifiers 1

IdentifierTypeStateIssuer
0196011MedicaidMA

Other names 1

  • Dr. Michelle L. Liblanc Former name

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
I20101110000779 MA Practitioner - Pediatric Medicine 5496940926 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric Medicine
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acton Medical Associates PCGroup PAC ID 7315919404, 34 clinicians

Practice addresses (Care Compare)

321 Main St
Acton, MA 01720-3718
Phone (978) 635-8700

Merit-based Incentive Payment System (MIPS)

Final score
87.03 of 100Reported as group
Quality
86.03
Promoting interoperability
99
Improvement activities
40
Cost
71.56

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
213482MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Acton Medical Associates, PC Pediatrics CurrentSince Aug 24, 2010 Accepting new patients

Locations

45 Discovery Way
Acton, MA 01720

321 Main St
Acton, MA 01720
Phone (978) 263-1131

231 Ayer Rd
Harvard, MA 01451

Interoperability endpoints

  • Direct secure messaging: michelle.travassos@amapc1.eclinicaldirectplus.com
  • FHIR API: https://fhir4.healow.com/fhir/r4/FIBBCD

Organizations & group practices 1

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205825577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "321 MAIN ST",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017203718",
            "telephone_number": "978-263-0680",
            "fax_number": "978-263-4880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 MAIN ST",
            "city": "ACTON",
            "state": "MA",
            "postal_code": "017203718",
            "telephone_number": "978-263-0680",
            "fax_number": "978-263-4880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAVASSOS",
        "first_name": "MICHELLE",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "213482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0196011",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "LIBLANC",
            "middle_name": "L.",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Acton, MA

Sources for this page

Verify at the official NPI Registry.