Individual provider Active NPI

Sameer Gaonkar, MD

  • Internal Medicine Physician
  • Medford, MA
National Provider Identifier
1245305325
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
212835 Issued in MA
Practice address
101 Main St Ste 116
Medford, MA 02155-4530
Phone
(781) 620-4894
Fax
(781) 395-0759
NPI assigned
Nov 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 212835 MA
Internal Medicine Physician 207R00000X 212835 MA Primary

Addresses

Primary practice location

101 Main St Ste 116
Medford, MA 02155-4530

Mailing address

101 Main St Ste 116
Medford, MA 02155-4530
Phone (781) 620-4894

Other practice location 1

103 Garland St
Everett, MA 02149-5066
Phone (617) 381-7150

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
I20050829000786 MA Practitioner - Family PracticePractitioner - Emergency Medicine 6800827916 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Emergency Medicine
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Urgent Care Operations PCGroup PAC ID 6406141217, 39 clinicians

Practice addresses (Care Compare)

50 Dodge St
Suite 104
Beverly, MA 01915-1765
Phone (978) 922-2171

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
212835MAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care Operations, PC CurrentSince Oct 1, 2016 Accepting new patients
Urgent Care Operations PC CurrentSince Oct 1, 2016 Accepting new patients
Beth Israel Lahey Health Specialty Care, Inc. Internal Medicine CurrentSince Apr 27, 2020 Accepting new patients
Cambridge Public Health Commission Past Accepting new patients
St. Anthony Home Medical Equipment Past Accepting new patients

Locations

50 Dodge St
Ste 104
Beverly, MA 01915
Phone (978) 922-2171

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

480 Maple St
Danvers, MA 01923
Phone (978) 304-8380

129 Turnpike St
North Andover, MA 01845
Phone (978) 470-0800

15 Railroad Ave
South Hamilton, MA 01982
Phone (978) 468-7381

Organizations & group practices 5

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": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1245305325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 MAIN ST STE 116",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554530",
            "telephone_number": "781-620-4894",
            "fax_number": "781-395-0759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MAIN ST STE 116",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554530",
            "telephone_number": "781-620-4894",
            "fax_number": "781-395-0759"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 Garland St",
            "address_purpose": "LOCATION",
            "city": "Everett",
            "state": "MA",
            "postal_code": "021495066",
            "country_code": "US",
            "telephone_number": "617-381-7150",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GAONKAR",
        "first_name": "SAMEER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "212835",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "212835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Medford, MA

Sources for this page

Verify at the official NPI Registry.