NPIMap

Individual provider Active NPI

David Nesanelis, M.D.

  • Internal Medicine Physician
  • Leominster, MA
National Provider Identifier
1518287416
Registry record updated Nov 4, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
253172 Issued in MA
Practice address
60 Hospital Rd
Leominster, MA 01453-2205
Phone
(978) 466-4169
Fax
(978) 466-4164
NPI assigned
Jun 3, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 253172 MA Primary

Addresses

Primary practice location

60 Hospital Rd
Leominster, MA 01453-2205

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885

Other practice location 1

100 South Street
Southbridge, MA 01550-4051
Phone (508) 765-9771

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address dnesanelis310836@UmassMemorial.direct-ci.com
FHIR URL https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120919000094 MA Practitioner - Internal Medicine 8820246721 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

60 Hospital Rd
Leominster, MA 01453-2205
Phone (978) 466-2257

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
82.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
253172MAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Heywood Memorial Hospital CurrentSince Aug 1, 2020 Accepting new patients
Henry Heywood Memorial Hospital CurrentSince Aug 1, 2020 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Apr 30, 2020 Accepting new patients
Umass Memorial Medical Group Inc Internal Medicine CurrentSince Apr 30, 2020 Accepting new patients
Athol Memorial Hospital Incorporated CurrentSince Aug 1, 2020 Accepting new patients
Umass Memorial Health-Harrington Hospital Inc Past Accepting new patients

Locations

2033 Main St
Athol, MA 01331
Phone (978) 249-1295

242 Green St
Gardner, MA 01440
Phone (978) 258-4734

60 Hospital Rd
Leominster, MA 01453
Phone (978) 466-2000

100 South St
Southbridge, MA 01550
Phone (508) 764-8012

100 South St
Ste 102
Southbridge, MA 01550
Phone (508) 765-7860

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

593 Eddy St
#7
Providence, RI 02903
Phone (401) 444-3565

Interoperability endpoints

  • Direct secure messaging: dnesanelis310836@umassmemorial.direct-ci.com

Organizations & group practices 6

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 6

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": "1275523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1518287416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885",
            "fax_number": "508-334-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 HOSPITAL RD",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014532205",
            "telephone_number": "978-466-4169",
            "fax_number": "978-466-4164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 South Street",
            "address_purpose": "LOCATION",
            "city": "Southbridge",
            "state": "MA",
            "postal_code": "015504051",
            "country_code": "US",
            "telephone_number": "508-765-9771",
            "fax_number": "508-909-7735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NESANELIS",
        "first_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-03",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "253172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dnesanelis310836@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "60 Hospital Rd",
            "city": "Leominster",
            "state": "MA",
            "country_code": "US",
            "postal_code": "014532205",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "60 Hospital Rd",
            "city": "Leominster",
            "state": "MA",
            "country_code": "US",
            "postal_code": "014532205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Leominster, MA

Sources for this page

Verify at the official NPI Registry.