NPIMap

Individual provider Active NPI

Michael Charles Ollendieck, MD

  • Internal Medicine Physician
  • Nashua, NH
National Provider Identifier
1235104126
Registry record updated May 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
11457 Issued in NH
Practice address
5 Dow Jones Ave
Nashua, NH 03062-3089
Phone
(603) 889-3667
NPI assigned
Feb 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 11457 NH Primary

Addresses

Primary practice location

5 Dow Jones Ave
Nashua, NH 03062-3089

Mailing address

PO Box 3677
Nashua, NH 03061-3677
Phone (603) 577-7900

Other identifiers 3

IdentifierTypeStateIssuer
0150461MedicaidMA
J24080OtherMABCBS MA
210491OtherMATUFTS HEALTH PLAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20170922001665 NH Practitioner - Internal Medicine 7719065135 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Foundation Medical Partners IncGroup PAC ID 9436140456, 313 clinicians

Practice addresses (Care Compare)

5 Dow Jones Ave
Nashua, NH 03062-3089
Phone (603) 889-3667

Hospital & facility affiliations

  • Home Health & Hospice Care Home health agency, Merrimack, NH, CCN 307017
  • Amedisys Home Health Home health agency, Portsmouth, NH, CCN 307006
  • Southern NH Medical Center Hospital, Nashua, NH, CCN 300020
  • St Joseph Hospital Hospital, Nashua, NH, CCN 300011
  • Elliot Hospital Hospital, Manchester, NH, CCN 300012
  • Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Foundation Medical Partners Inc Internal Medicine CurrentSince Sep 1, 2017 Accepting new patients
Foundation Medical Partners Inc. CurrentSince Sep 1, 2017 Accepting new patients
University Emergency Medicine Past Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

10 Jones Rd
Milford, NH 03055
Phone (603) 672-7600

5 Dow Jones Ave
Nashua, NH 03062
Phone (603) 889-3667

Interoperability endpoints

  • Direct secure messaging: mollendieck92191@direct.solutionhealth.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 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": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556755200000",
    "number": "1235104126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3677",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030613677",
            "telephone_number": "603-577-7900",
            "fax_number": "603-577-7972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 DOW JONES AVE",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030623089",
            "telephone_number": "603-889-3667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLLENDIECK",
        "first_name": "MICHAEL",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2019-05-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NH",
            "license": "11457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0150461",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "J24080",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "210491",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashua, NH

Sources for this page

Verify at the official NPI Registry.