Individual provider Active NPI

Kevin F. Delacey, M.D.

  • Internal Medicine Physician
  • Auburn, MA
National Provider Identifier
1447231402
Registry record updated Dec 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
50985 Issued in MA
Practice address
489 Washington St
Auburn, MA 01501-5709
Phone
(508) 832-9646
Fax
(508) 832-7862
NPI assigned
Nov 8, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 27, 2021

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 50985 MA Primary

Addresses

Primary practice location

489 Washington St
Auburn, MA 01501-5709

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885

Other identifiers 1

IdentifierTypeStateIssuer
6172598MedicaidMA

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
I20050323000455 MA Practitioner - Internal Medicine 5294781290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Massachusetts Medical School, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

489 Washington St
Auburn, MA 01501-5709
Phone (508) 832-9646

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
50985MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group Inc Internal Medicine CurrentSince Dec 31, 2021 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Dec 31, 2021 Accepting new patients

Locations

489 Washington St
Auburn, MA 01501
Phone (508) 832-2628

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Organizations & group practices 2

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.

Hospital & facility affiliations 6

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": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640563200000",
    "number": "1447231402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885",
            "fax_number": "508-334-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 WASHINGTON ST",
            "city": "AUBURN",
            "state": "MA",
            "postal_code": "015015709",
            "telephone_number": "508-832-9646",
            "fax_number": "508-832-7862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELACEY",
        "first_name": "KEVIN",
        "middle_name": "F.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "50985",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6172598",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, MA

Sources for this page

Verify at the official NPI Registry.