Melisa Anne Poulos, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

269498 Issued in MA

Practice address

680 Centre St
Brockton, MA 02302-3308

Phone

(508) 941-7400

Fax

(508) 941-0895

NPI assigned

Jun 22, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Emergency Medicine

Education

University of Vermont College of Medicine, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brockton Hospital, Inc.Group PAC ID 4082504733, 36 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Signature Healthcare Brockton Hospital Hospital, Brockton, MA, CCN 220052

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mpoulos8205@direct.bmc.masshiway.net
• Direct secure messaging: melisa.poulos@direct.signature.masshiway.net

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.

• Brockton Hospital, Inc.

  • General Acute Care Hospital
  • Brockton, MA
  • NPI 1063431286
  Medicare reassignment Care Compare group NPD
• Signature Healthcare Medical Group Inc

  • Internal Medicine Physician
  • Brockton, MA
  • NPI 1508804949
  Medicare reassignment NPD
• Steward Emergency Physicians, Inc

  • Emergency Medicine Physician
  • Ayer, MA
  • NPI 1780971275
  Medicare reassignment NPD
• Boston Medical Center Corporation

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1346218294
  NPD
• Brockton Hospital, Inc.

  • Community/Retail Pharmacy
  • East Bridgewater, MA
  • NPI 1033084462
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Brockton Hospital, Inc.

  • General Acute Care Hospital
  • Brockton, MA
  • NPI 1063431286
  Care Compare affiliation

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

{
    "created_epoch": "1277164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693872000000",
    "number": "1497076632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 CENTRE ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023023308",
            "telephone_number": "508-941-7400",
            "fax_number": "508-941-0895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 CENTRE ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023023308",
            "telephone_number": "508-941-7400",
            "fax_number": "508-941-0895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POULOS",
        "first_name": "MELISA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-22",
        "last_updated": "2023-09-05",
        "certification_date": "2023-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "269498",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Grace Postma
• Kathryn Jean Potenzone-Chiariello I, NP
• Bethany Potter
• Ashley Marie Potts, MSW
• George William Poulos, M.D., PH.D.
• Angie Powers
• Kellie Powers
• Mamatha Prabhakara, M.D.
• Pratik S Pradhan, M.D.
• Renu B Prakash, MD

• Emergency Medicine Physician in Brockton, MA
• Providers in Brockton, MA by specialty
• Emergency Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.