Active NPI
Sarah Gyllstrom, M.D.
- Pediatrics Physician
- Worcester, MA
National Provider Identifier
1548589542
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 244519
- Practice address
- 55 Lake Ave N
Pediatric Residency
Worcester, MA 01655-0002 - Phone
- (508) 334-1000
- NPI assigned
- Jun 1, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 244519 | MA | Primary |
Addresses
Primary practice location
55 Lake Ave N
Pediatric Residency
Worcester, MA 01655-0002
Mailing address
55 Lake Ave N
Pediatric Residency
Worcester, MA 01655-0002
Phone (508) 334-1000
Other names 1
- Sarah Freilich
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 244519 | MA | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Reliant Medical Group, Inc | Pediatrics | Past | Accepting new patients |
Interoperability endpoints
- sarah.gyllstrom.npi1548589542.reliant@direct.optumcare.masshiway.net
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275350400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1282780800000",
"number": "1548589542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 LAKE AVE N",
"address_2": "PEDIATRIC RESIDENCY",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016550002",
"telephone_number": "508-334-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 LAKE AVE N",
"address_2": "PEDIATRIC RESIDENCY",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016550002",
"telephone_number": "508-334-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GYLLSTROM",
"first_name": "SARAH",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-06-01",
"last_updated": "2010-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "MA",
"license": "244519",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "SARAH",
"last_name": "FREILICH",
"credential": "M.D.",
"code": "5",
"type": "Other Name"
}
]
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.