Individual provider Active NPI

Charles J McInnis, M.D.

  • Internal Medicine Physician
  • Westwood, MA
National Provider Identifier
1346343969
Registry record updated Nov 7, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
56701 Issued in MA
Practice address
541 High Street
Westwood, MA 02090
Phone
(781) 326-1128
Fax
(781) 326-1438
NPI assigned
Sep 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2013

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 56701 MA Primary

Addresses

Primary practice location

541 High Street
Westwood, MA 02090

Mailing address

541 High Street
Westwood, MA 02090
Phone (781) 326-1128

Other identifiers 1

IdentifierTypeStateIssuer
3005038MedicaidMA

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
I20050330000551 MA Practitioner - Internal MedicinePractitioner - Addiction Medicine 3375599582 Practice locations: Medfield, MA

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Addiction Medicine
Education
Tufts University School of Medicine, 1983
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

266 Main St
Medfield, MA 02052-2064
Phone (781) 326-1128

541 High St
Westwood, MA 02090-1628

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56701MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Laird Hospital, Inc. PastSince Apr 1, 2013 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383782400000",
    "number": "1346343969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 HIGH STREET",
            "city": "WESTWOOD",
            "state": "MA",
            "postal_code": "02090",
            "telephone_number": "781-326-1128",
            "fax_number": "781-326-1438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 HIGH STREET",
            "city": "WESTWOOD",
            "state": "MA",
            "postal_code": "02090",
            "telephone_number": "781-326-1128",
            "fax_number": "781-326-1438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINNIS",
        "first_name": "CHARLES",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2013-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "56701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3005038",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westwood, MA

Sources for this page

Verify at the official NPI Registry.