Individual provider Active NPI

Michael Damian Chmielewski, PA-C

  • Physician Assistant
  • Attleboro, MA
National Provider Identifier
1396298584
Registry record updated Apr 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
211 Park St
Attleboro, MA 02703-3143
Phone
(508) 838-3048
NPI assigned
Jul 25, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

211 Park St
Attleboro, MA 02703-3143

Mailing address

211 Park Street
Attleboro, MA 02703
Phone (508) 838-3048

Other practice location 1

208 Mill Rd
Fairhaven, MA 02719-5208
Phone (508) 973-2432

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mchmielewski44195@direct.southcoast.org

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170616000976 MA Practitioner - Physician Assistant 1254609191 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cambridge Public Health Commission CurrentSince Aug 11, 2024 Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Aug 1, 2018 Accepting new patients
Cambridge Public Health Commission Current Accepting new patients
Southcoast Physicians Group, Inc. CurrentSince Aug 1, 2018 Accepting new patients

Locations

1493 Cambridge St
Cambridge, MA 02139
Phone (617) 665-1185

103 Garland St
Everett, MA 02149
Phone (617) 381-7150

208 Mill Rd
Fairhaven, MA 02719
Phone (508) 758-3781

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

88 Washington St
Taunton, MA 02780
Phone (508) 828-7000

Interoperability endpoints

  • Direct secure messaging: mchmielewski75112@direct.challiance.masshiway.net
  • Direct secure messaging: mchmielewski44195@direct.southcoast.org

Organizations & group practices 5

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": "1469404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587427200000",
    "number": "1396298584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 PARK STREET",
            "city": "ATTLEBORO",
            "state": "MA",
            "postal_code": "02703",
            "telephone_number": "508-838-3048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 PARK ST",
            "city": "ATTLEBORO",
            "state": "MA",
            "postal_code": "027033143",
            "telephone_number": "508-838-3048"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "208 Mill Rd",
            "address_purpose": "LOCATION",
            "city": "Fairhaven",
            "state": "MA",
            "postal_code": "027195208",
            "country_code": "US",
            "telephone_number": "508-973-2432",
            "fax_number": "508-973-2435",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHMIELEWSKI",
        "first_name": "MICHAEL",
        "middle_name": "DAMIAN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-25",
        "last_updated": "2020-04-21",
        "certification_date": "2020-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mchmielewski44195@direct.southcoast.org",
            "affiliation": "N",
            "endpointDescription": "Southcoast Health Epic Direct Address",
            "address_1": "208 Mill Rd",
            "city": "Fairhaven",
            "state": "MA",
            "country_code": "US",
            "postal_code": "027195208",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Attleboro, MA

Sources for this page

Verify at the official NPI Registry.