Individual provider Active NPI

Noel Samuel John Wheeler, MD

  • Pulmonary Disease Physician
  • Beverly, MA
National Provider Identifier
1407893373
Registry record updated Oct 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
261560 Issued in MA
Practice address
77 Herrick St
Lahey Pulmonary, Beverly
Beverly, MA 01915-2734
Phone
(978) 998-4601
Fax
(978) 998-4973
NPI assigned
Jun 1, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 261560 MA Primary

Addresses

Primary practice location

77 Herrick St
Lahey Pulmonary, Beverly
Beverly, MA 01915-2734

Mailing address

77 Herrick St
Lahey Pulmonary, Beverly
Beverly, MA 01915-2734
Phone (978) 998-4601

Other identifiers 3

IdentifierTypeStateIssuer
3074414MedicaidNH
1407893373MedicaidME
110101859AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20040816000366 NH Practitioner - Pulmonary DiseasePractitioner - Internal MedicinePractitioner - Critical Care (Intensivists) 7911970280 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Core Physicians, LLC CurrentSince Nov 5, 2020 Accepting new patients
Core Physicians LLC CurrentSince Nov 5, 2020 Accepting new patients
Medical Associates of Brevard LLC Past Accepting new patients

Locations

3 Alumni Dr
Ste 301
Exeter, NH 03833
Phone (603) 658-1180

7 Holland Way
#1
Exeter, NH 03833

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539561600000",
    "number": "1407893373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 HERRICK ST",
            "address_2": "LAHEY PULMONARY, BEVERLY",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019152734",
            "telephone_number": "978-998-4601",
            "fax_number": "978-998-4973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 HERRICK ST",
            "address_2": "LAHEY PULMONARY, BEVERLY",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019152734",
            "telephone_number": "978-998-4601",
            "fax_number": "978-998-4973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHEELER",
        "first_name": "NOEL",
        "middle_name": "SAMUEL JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2018-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MA",
            "license": "261560",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3074414",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1407893373",
            "state": "ME"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110101859A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

Verify at the official NPI Registry.