Bertille Octavie Mavegam Tango Assoumou M

Primary specialty

Nutrition Education NutritionistTaxonomy code 133NN1002X

Practice address

22 Atwood Dr FL 1
Northampton, MA 01060-4267

Phone

(413) 586-1601

Fax

(413) 923-9304

NPI assigned

Aug 23, 2016

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Mass General Brigham Medical Group Western Massachusetts Inc

  • Family Medicine Physician
  • Northampton, MA
  • NPI 1295787919
  NPD (past)

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

{
    "created_epoch": "1471910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471910400000",
    "number": "1336694066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 ATWOOD DR FL 1",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010604267",
            "telephone_number": "413-586-1601",
            "fax_number": "413-923-9304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 ATWOOD DR FL 1",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010604267",
            "telephone_number": "413-586-1601",
            "fax_number": "413-923-9304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAVEGAM TANGO ASSOUMOU M",
        "first_name": "BERTILLE OCTAVIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-23",
        "last_updated": "2016-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arthur Matsuk
• Maria de Lourdes Mattei, PH.D.
• Lynn Marsh Matteson, PSY.D.
• Anne Elizabeth Matthews, B.S.
• Anne E Mattson, PHARMD
• Virginia Maxwell, LICSW
• David N Mayer, MD
• Janet S. Mazziotti, MSW, LICSW
• Allyson Mazzuchi
• Elizabeth Reid McAnulty, MS OTR

• Nutrition Education Nutritionist in Northampton, MA
• Providers in Northampton, MA by specialty
• Nutrition Education Nutritionist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2016; 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.