Modern Care Medical Group, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

243604 Issued in MA

Legal business name

MODERN CARE MEDICAL GROUP, LLC

Practice address

1075 Westford St
Suite 204
Lowell, MA 01851-2716

Phone

(978) 452-2000

Fax

(978) 452-2001

NPI assigned

Sep 19, 2011

Organization subpart

No

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

Authorized official

Name

Steve Hardie

Title

Practice Operations Manager

Phone

(978) 452-2000

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1316390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337817600000",
    "number": "1235411901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 WESTFORD ST",
            "address_2": "SUITE 204",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018512716",
            "telephone_number": "978-452-2000",
            "fax_number": "978-452-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 WESTFORD ST",
            "address_2": "SUITE 204",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018512716",
            "telephone_number": "978-452-2000",
            "fax_number": "978-452-2001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN CARE MEDICAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-19",
        "last_updated": "2012-05-24",
        "status": "A",
        "authorized_official_last_name": "HARDIE",
        "authorized_official_first_name": "STEVE",
        "authorized_official_title_or_position": "PRACTICE OPERATIONS MANAGER",
        "authorized_official_telephone_number": "978-452-2000"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "243604",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP PTAN",
            "identifier": "0025815",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PROVIDER PTAN",
            "identifier": "002581601",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arlene Mita, CNM
• Alice Mitchell, CPNP-PC
• Jennifer Mitchell, MSW
• Kristen Mitchell, MS, ATC
• Sibonginkosi Mngometulu
• Caroline Moe
• Mohamed Mohuddin
• Kara E Moloney, CNP
• Franyris Moncion
• Tamara Omayra Mondesir, M.ED

• Family Medicine Physician in Lowell, MA
• Providers in Lowell, MA by specialty
• Family Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.