NPIMap

Individual provider Active NPI

Kevin G Epstein, MD

  • Internal Medicine Physician
  • Indian Orchard, MA
National Provider Identifier
1265443816
Registry record updated Dec 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
150374 Issued in MA
Practice address
811 Worcester St
Indian Orchard, MA 01151-1001
Phone
(413) 439-0609
Fax
(413) 439-0623
NPI assigned
Aug 10, 2006
Last updated
Dec 27, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2007

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 150374 MA Primary

Addresses

Primary practice location

811 Worcester St
Indian Orchard, MA 01151-1001

Mailing address

811 Worcester St
Indian Orchard, MA 01151-1001
Phone (413) 439-0609

Other identifiers 1

IdentifierTypeStateIssuer
3153924MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20070809000258 MA Practitioner - Internal Medicine 1355432006 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Boston University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Orchard Medical Associates LLCGroup PAC ID 6204929938, 3 clinicians

Practice addresses (Care Compare)

835 Worcester St
Indian Orchard, MA 01151-1001
Phone (413) 439-0609

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
150374MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Orchard Medical Associates LLC Internal Medicine CurrentSince Jul 1, 2007 Accepting new patients
Baystate Affiliated Practice Organization Internal Medicine Past Accepting new patients
Renal and Transplant Associates of New England PC Past Accepting new patients
Baystate Medical Practices, Inc Internal Medicine Past Accepting new patients

Locations

811 Worcester St
Indian Orchard, MA 01151
Phone (413) 439-0609

835 Worcester St
Springfield, MA 01151
Phone (413) 439-0609

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 8

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": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198713600000",
    "number": "1265443816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 WORCESTER ST",
            "city": "INDIAN ORCHARD",
            "state": "MA",
            "postal_code": "011511001",
            "telephone_number": "413-439-0609",
            "fax_number": "413-439-0623"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 WORCESTER ST",
            "city": "INDIAN ORCHARD",
            "state": "MA",
            "postal_code": "011511001",
            "telephone_number": "413-439-0609",
            "fax_number": "413-439-0623"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EPSTEIN",
        "first_name": "KEVIN",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "150374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3153924",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Indian Orchard, MA

Sources for this page

Verify at the official NPI Registry.