Individual provider Active NPI

Kenneth K Gerweck, M.D.

  • Family Medicine Physician
  • East Cambridge, MA
National Provider Identifier
1497733752
Registry record updated Jul 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
213776 Issued in MA
Practice address
163 Gore St
East Cambridge, MA 02141-1119
Phone
(617) 665-3000
Fax
(617) 665-3099
NPI assigned
Jan 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 213776 MA Primary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 213776 MA

Addresses

Primary practice location

163 Gore St
East Cambridge, MA 02141-1119

Mailing address

163 Gore St
East Cambridge, MA 02141-1119
Phone (617) 665-3000

Other identifiers 1

IdentifierTypeStateIssuer
2063221MedicaidMA

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
I20040720000037 MA Practitioner - Family Practice 6507752920 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Massachusetts Medical School, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

163 Gore St
Cambridge, MA 02141-1119
Phone (617) 665-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
213776MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medical Associates-Ebnhc CurrentSince Jun 3, 2004 Accepting new patients
Cambridge Public Health Commission CurrentSince Dec 10, 2010 Accepting new patients
Cambridge Public Health Commission Current Accepting new patients
Neighborhealth Corporation Current Accepting new patients
Ernc Operating, LLC Past Accepting new patients

Locations

1493 Cambridge St
Cambridge, MA 02139
Phone (617) 665-1185

10 Grove St
East Boston, MA 02128
Phone (617) 569-5800

163 Gore St
East Cambridge, MA 02141
Phone (617) 499-6690

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

Interoperability endpoints

  • Direct secure messaging: kgerweck11144@direct.challiance.masshiway.net

Organizations & group practices 5

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 3

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": "1136505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374192000000",
    "number": "1497733752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "163 GORE ST",
            "city": "EAST CAMBRIDGE",
            "state": "MA",
            "postal_code": "021411119",
            "telephone_number": "617-665-3000",
            "fax_number": "617-665-3099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "163 GORE ST",
            "city": "EAST CAMBRIDGE",
            "state": "MA",
            "postal_code": "021411119",
            "telephone_number": "617-665-3000",
            "fax_number": "617-665-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERWECK",
        "first_name": "KENNETH",
        "middle_name": "K",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-06",
        "last_updated": "2013-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "213776",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MA",
            "license": "213776",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2063221",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Cambridge, MA

Sources for this page

Verify at the official NPI Registry.