Individual provider Active NPI

Vanpat Pensuwan, MD

  • Family Medicine Physician
  • Somerville, MA
National Provider Identifier
1487144689
Registry record updated Mar 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
287616 Issued in MA
Practice address
26 Central St
Somerville, MA 02143-2827
Phone
(617) 665-3370
NPI assigned
May 14, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2022

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 287616 MA Primary

Addresses

Primary practice location

26 Central St
Somerville, MA 02143-2827

Mailing address

26 Central St
Somerville, MA 02143-2827

Other practice location 1

195 Canal St
Malden, MA 02148-6701
Phone (781) 338-0500

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
I20220318002353 MA Practitioner - Family Practice 9234527011 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Rutgers, Robert Woood Johnson Medical School, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

103 Garland St
Everett, MA 02149-5066
Phone (617) 389-6270

195 Canal St
Malden, MA 02148-6701
Phone (781) 338-0500

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cambridge Public Health Commission CurrentSince Dec 3, 2021 Accepting new patients
Cambridge Public Health Commission CurrentSince Dec 3, 2021 Accepting new patients

Locations

103 Garland St
Everett, MA 02149
Phone (617) 381-7150

195 Canal St
Malden, MA 02148
Phone (781) 338-0055

1 Cabot Rd
Fl 2
Medford, MA 02155
Phone (617) 591-6840

26 Central St
Somerville, MA 02143
Phone (617) 591-6033

Interoperability endpoints

  • Direct secure messaging: vpensuwan85493@direct.challiance.masshiway.net

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 2

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": "1526256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646265600000",
    "number": "1487144689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 CENTRAL ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021432827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 CENTRAL ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021432827",
            "telephone_number": "617-665-3370"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "195 Canal St",
            "address_purpose": "LOCATION",
            "city": "Malden",
            "state": "MA",
            "postal_code": "021486701",
            "country_code": "US",
            "telephone_number": "781-338-0500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PENSUWAN",
        "first_name": "VANPAT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-14",
        "last_updated": "2022-03-03",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "287616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

Verify at the official NPI Registry.