Active NPI
Mark R Vanelli, M.D.
- Psychiatry Physician
- Westborough, MA
National Provider Identifier
1447268222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 60076
- Practice address
- 21 Longmeadow Rd
Moak Associates
Westborough, MA 01581-2419 - Phone
- (508) 898-8650
- Fax
- (508) 870-9793
- NPI assigned
- Aug 4, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 60076 | MA | Primary |
Addresses
Primary practice location
21 Longmeadow Rd
Moak Associates
Westborough, MA 01581-2419
Mailing address
PO Box 260
Moak Associates
Westborough, MA 01581-0260
Phone (508) 898-8650
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 15-00999 | Other | MA | EVERCARE |
| J09205 | Other | MA | BLUE SHIELD |
| 3056244 | Medicaid | MA | |
| 776748 | Other | MA | TUFTS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60076 | MA | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1209686400000",
"number": "1447268222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 260",
"address_2": "MOAK ASSOCIATES",
"city": "WESTBOROUGH",
"state": "MA",
"postal_code": "015810260",
"telephone_number": "508-898-8650",
"fax_number": "508-870-9793"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21 LONGMEADOW RD",
"address_2": "MOAK ASSOCIATES",
"city": "WESTBOROUGH",
"state": "MA",
"postal_code": "015812419",
"telephone_number": "508-898-8650",
"fax_number": "508-870-9793"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANELLI",
"first_name": "MARK",
"middle_name": "R",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-04",
"last_updated": "2008-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "60076",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EVERCARE",
"identifier": "15-00999",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "J09205",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3056244",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "776748",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Westborough, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.