Individual provider Active NPI

Paul Sedgwick, MD

  • Internal Medicine Physician
  • Worcester, MA
National Provider Identifier
1366559460
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
57340 Issued in MA
Practice address
200 Lincoln St
Worcester, MA 01605-2528
Phone
(508) 755-1222
Fax
(508) 754-9479
NPI assigned
Aug 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 57340 MA Primary

Addresses

Primary practice location

200 Lincoln St
Worcester, MA 01605-2528

Mailing address

200 Lincoln St
Worcester, MA 01605-2528
Phone (508) 755-1222

Other identifiers 1

IdentifierTypeStateIssuer
3100197MedicaidMA

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
I20050429000412 MA Practitioner - Internal Medicine 7012956998 Practice locations: Worcester, MA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Massachusetts Medical School, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

200 Lincoln St
Worcester, MA 01605-2528
Phone (508) 755-1222

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
57340MAMDInternal Medicine Physician

Hospital & facility affiliations 5

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": "1156377600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366559460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 LINCOLN ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052528",
            "telephone_number": "508-755-1222",
            "fax_number": "508-754-9479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 LINCOLN ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052528",
            "telephone_number": "508-755-1222",
            "fax_number": "508-754-9479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEDGWICK",
        "first_name": "PAUL",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "57340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3100197",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.