Individual provider Active NPI

Michael J Smith, D.O.

  • Family Medicine Physician
  • Bourne, MA
National Provider Identifier
1306830484
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
223770 Issued in NY
Practice address
2 Technology Park Dr
Bourne, MA 02532-8341
Phone
(508) 743-9543
Fax
(508) 743-8335
NPI assigned
Sep 6, 2005
Last updated
Mar 7, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 223770 NY Primary

Addresses

Primary practice location

2 Technology Park Dr
Bourne, MA 02532-8341

Mailing address

139 Sandwich St
Plymouth, MA 02360-2449
Phone (508) 743-9543

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
I20140916000244 MA Practitioner - Family Practice 1951405729 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
New York College of Osteo Medicine of New York Institute of Technology, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians

Practice addresses (Care Compare)

100 2ND Ave
Needham, MA 02494-2809
Phone (781) 726-4800

133 Brookline Ave
Boston, MA 02215-3904
Phone (617) 421-1000

2 Technology Park Dr
Suite a
Bourne, MA 02532-8341
Phone (508) 743-9543

36 Shops at 5 Way
Plymouth, MA 02360-2677
Phone (774) 608-3700

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Mar 1, 2020 Accepting new patients
Atrius Health, Inc. CurrentSince Jun 1, 2017 Accepting new patients
Atrius Health, Inc. Family Medicine CurrentSince Jun 1, 2017 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Mar 1, 2020 Accepting new patients
Atrius Health, Inc. Current Accepting new patients
Mid-Hudson Family Health Institute Family Medicine Past Accepting new patients

Locations

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

362 Court St
Plymouth, MA 02360
Phone (508) 746-7543

Interoperability endpoints

  • Direct secure messaging: msmithdo194894@direct.atrius.masshiway.net

Organizations & group practices 6

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 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1125964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1306830484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 SANDWICH ST",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602449",
            "telephone_number": "508-743-9543",
            "fax_number": "508-743-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 TECHNOLOGY PARK DR",
            "city": "BOURNE",
            "state": "MA",
            "postal_code": "025328341",
            "telephone_number": "508-743-9543",
            "fax_number": "508-743-8335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-06",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NY",
            "license": "223770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bourne, MA

Sources for this page

Verify at the official NPI Registry.