NPIMap

Organization Active NPI

Hallmark Health Medical Associates Inc

  • Nurse Practitioner
  • Medford, MA
National Provider Identifier
1255964391
Registry record updated Feb 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
Legal business name
HALLMARK HEALTH MEDICAL ASSOCIATES INC
Practice address
170 Governors Ave
Medford, MA 02155-1643
Phone
(781) 338-7170
Fax
(781) 338-7173
NPI assigned
Feb 18, 2020
Organization subpart
Yes
Parent organization
MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 18, 2020

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

Authorized official

Name
Michael Patrick Connelly
Title
Executive Vice President, Cfo
Phone
(781) 979-3028

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103T00000X
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X Primary
Clinical Nurse SpecialistGroup: 193200000X MULTI-SPECIALTY GROUP 364S00000X

Addresses

Primary practice location

170 Governors Ave
Medford, MA 02155-1643

Mailing address

PO Box 3237
Woburn, MA 01888-3237
Phone (781) 338-7170

Other names 1

  • HHMA TPP/THP Non-Physician Other name

National Provider Directory

National Provider Directory
Tax ID family
Hallmark Health Medical Associates Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1581984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581984000000",
    "number": "1255964391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3237",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018883237",
            "telephone_number": "781-338-7170",
            "fax_number": "781-338-7173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 GOVERNORS AVE",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021551643",
            "telephone_number": "781-338-7170",
            "fax_number": "781-338-7173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALLMARK HEALTH MEDICAL ASSOCIATES INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MELROSEWAKEFIELD HEALTHCARE PARENT CORPORATION",
        "enumeration_date": "2020-02-18",
        "last_updated": "2020-02-18",
        "certification_date": "2020-02-18",
        "status": "A",
        "authorized_official_last_name": "CONNELLY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT, CFO",
        "authorized_official_telephone_number": "781-979-3028"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "364S00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HHMA TPP/THP Non-Physician",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Medford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2020; 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.