Individual provider Active NPI

Toby M Milgrome, MD

  • Pediatrics Physician
  • Leominster, MA
National Provider Identifier
1417919184
Registry record updated Feb 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
223080 Issued in MA
Practice address
165 Mill St
Leominster, MA 01453
Phone
(978) 534-6500
Fax
(978) 534-2991
NPI assigned
Apr 6, 2006
Last updated
Feb 18, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 223080 MA Primary

Addresses

Primary practice location

165 Mill St
Leominster, MA 01453

Mailing address

630 Plantation St
Worcester, MA 01605
Phone (978) 534-6500

Other identifiers 18

IdentifierTypeStateIssuer
042472266OtherTHREE RIVERS
042472266OtherTRICARE CHAMPUS
5624765OtherAETNA US HEALTHCARE
2087570OtherMEDICAID WELFARE
AA19860OtherHARVARD PILGRIM
83258OtherCHILDRENS MED SECURITY
91201OtherFALLON COMMUNITY HEALTH
J28304OtherBLUE SHIELD HMO BLUE
J28304OtherBLUE SHIELD INDEMNITY
2087570MedicaidMA
J28304OtherBLUE CARE ELECT
5550803OtherFIRST HEALTH
784163OtherMVP HEALTH CARE
042472266OtherONE HEALTH PLAN
419293OtherTUFTS HEALTH PLAN
A37777OtherMEDICARE B
042472266OtherPRIVATE HEALTHCARE SYSTEM
5015435OtherCIGNA HEALTH PLAN

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
I20041028000337 MA Practitioner - Pediatric Medicine 1456313832 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Medical Group, Inc Pediatrics CurrentSince Jan 18, 2010 Accepting new patients

Locations

165 Mill St
Leominster, MA 01453
Phone (978) 466-3208

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

630 Plantation St
Worcester, MA 01605
Phone (508) 368-5529

630 Plantation St
Fl 12
Worcester, MA 01605
Phone (508) 368-5529

Interoperability endpoints

  • Direct secure messaging: toby.milgrome.npi1417919184.reliant@direct.optumcare.masshiway.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1144281600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234915200000",
    "number": "1417919184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 PLANTATION ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01605",
            "telephone_number": "978-534-6500",
            "fax_number": "978-534-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 MILL ST",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "01453",
            "telephone_number": "978-534-6500",
            "fax_number": "978-534-2991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILGROME",
        "first_name": "TOBY",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-06",
        "last_updated": "2009-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "223080",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THREE RIVERS",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE CHAMPUS",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "5624765",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID WELFARE",
            "identifier": "2087570",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "AA19860",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHILDRENS MED SECURITY",
            "identifier": "83258",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON COMMUNITY HEALTH",
            "identifier": "91201",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD HMO BLUE",
            "identifier": "J28304",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD INDEMNITY",
            "identifier": "J28304",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2087570",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE ELECT",
            "identifier": "J28304",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "5550803",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP HEALTH CARE",
            "identifier": "784163",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ONE HEALTH PLAN",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "419293",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE B",
            "identifier": "A37777",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTHCARE SYSTEM",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTH PLAN",
            "identifier": "5015435",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leominster, MA

Sources for this page

Verify at the official NPI Registry.