Marc A Theroux, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

72558 Issued in MA

Practice address

534 Prospect St
Fall River, MA 02720-5239

Phone

(508) 973-7766

Fax

(508) 973-7753

NPI assigned

Oct 4, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MA, RI2 enrollments

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 2

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Southcoast Hospitals Group, Inc

  • General Acute Care Hospital
  • Fall River, MA
  • NPI 1306871223
  Medicare reassignment NPD
• Southcoast Physicians Group, Inc.

  • Family Medicine Physician
  • Fairhaven, MA
  • NPI 1336137629

  RI

  Medicare reassignment
• Southcoast Hospitals Group Inc

  • Community/Retail Pharmacy
  • New Bedford, MA
  • NPI 1376565366
  NPD
• Southcoast Physicians Group, Inc.

  • Emergency Medicine Physician
  • Fairhaven, MA
  • NPI 1861830143

  Internal Medicine

  NPD

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1497742514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL RD",
            "address_2": "STE 180",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195252",
            "telephone_number": "508-973-2000",
            "fax_number": "508-973-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "534 PROSPECT ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027205239",
            "telephone_number": "508-973-7766",
            "fax_number": "508-973-7753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEROUX",
        "first_name": "MARC",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "72558",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD08048",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110048792A",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mtheroux6438@direct.southcoast.org",
            "affiliation": "N",
            "endpointDescription": "Southcoast Health Epic Direct Address",
            "address_1": "534 Prospect St",
            "city": "Fall River",
            "state": "MA",
            "country_code": "US",
            "postal_code": "027205239",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• The Stop & Shop Supermarket Company, LLC
• Kerline Theodore
• Mark Francis Theodore, MA, LSW
• Therapy Resources Management, LLC
• Deana Marie Theroux, MD
• Angela Jean Therrien, LMHC, LADC1
• Didi Pathak Theva, M.D.
• Phylicia Lee Thibeault
• Larry F Thiesen, MD
• Julie Thim

• Internal Medicine Physician in Fall River, MA
• Providers in Fall River, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.