Individual provider Active NPI

Cynthia Walendziewicz Brooks, MD

  • Family Medicine Physician
  • Marblehead, MA
National Provider Identifier
1427164474
Registry record updated Sep 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
231320 Issued in MA
Practice address
1 Widger Rd
North Shore Physicians Group
Marblehead, MA 01945-2146
Phone
(781) 631-5126
Fax
(781) 631-5175
NPI assigned
Aug 22, 2006
Last updated
Sep 22, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 231320 MA Primary

Addresses

Primary practice location

1 Widger Rd
North Shore Physicians Group
Marblehead, MA 01945-2146

Mailing address

1 Widger Rd
North Shore Physicians Group
Marblehead, MA 01945-2146
Phone (781) 631-5126

Other names 1

  • Cynthia Walendziewicz Former name

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
I20071001000788 MA Practitioner - Family Practice 8527153881 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1 Hutchinson Dr
Danvers, MA 01923-3748
Phone (978) 739-6950

1 Widger Rd
Marblehead, MA 01945-2146
Phone (781) 631-5726

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
231320MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Medical Group Northern Massachusetts Inc CurrentSince Sep 15, 2008 Accepting new patients

Locations

1 Hutchinson Dr
Danvers, MA 01923
Phone (978) 739-6950

1 Widger Rd
Marblehead, MA 01945
Phone (781) 631-5126

Interoperability endpoints

  • Direct secure messaging: walendziewicz.cynthia.nsmc@direct.partners.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.

Hospital & facility affiliations 4

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": "1156204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411344000000",
    "number": "1427164474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 WIDGER RD",
            "address_2": "NORTH SHORE PHYSICIANS GROUP",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019452146",
            "telephone_number": "781-631-5126",
            "fax_number": "781-631-5175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 WIDGER RD",
            "address_2": "NORTH SHORE PHYSICIANS GROUP",
            "city": "MARBLEHEAD",
            "state": "MA",
            "postal_code": "019452146",
            "telephone_number": "781-631-5126",
            "fax_number": "781-631-5175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALENDZIEWICZ BROOKS",
        "first_name": "CYNTHIA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-22",
        "last_updated": "2014-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "231320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CYNTHIA",
            "last_name": "WALENDZIEWICZ",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marblehead, MA

Sources for this page

Verify at the official NPI Registry.