Active NPI
Gina Martin Trachimowicz, MD
- Pediatrics Physician
- Worcester, MA
National Provider Identifier
1295885754
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 225567
- Practice address
- 55 Lake Ave N
Worcester, MA 01655-0002 - Phone
- (508) 856-3590
- NPI assigned
- Jan 10, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 225567 | MA | Primary |
Addresses
Primary practice location
55 Lake Ave N
Worcester, MA 01655-0002
Mailing address
1 Washburn Rd
Auburn, MA 01501-2320
Phone (508) 832-2335
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 225567 | MA | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Maine Neonatology Associates | Current | Accepting new patients | |
| Mainehealth | Past | Accepting new patients | |
| Saint Vincent Physician Services, Inc. | Pediatrics | Past | Accepting new patients |
Locations
22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179
Interoperability endpoints
- gtrachimowicz141057@direct.mmc.mainehealth.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.
-
- Neonatal-Perinatal Medicine Physician
- Portland, ME
- NPI 1417087883
-
- Family Medicine Physician
- Worcester, MA
- NPI 1013997329
Pediatrics
-
- General Acute Care Hospital
- Portland, ME
- NPI 1760436216
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168387200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1295885754",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1 WASHBURN RD",
"city": "AUBURN",
"state": "MA",
"postal_code": "015012320",
"telephone_number": "508-832-2335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 LAKE AVE N",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016550002",
"telephone_number": "508-856-3590"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRACHIMOWICZ",
"first_name": "GINA",
"middle_name": "MARTIN",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-10",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "225567",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.