Individual provider Active NPI

Anne Marie Treadup, MD

  • Family Medicine Physician
  • North Dartmouth, MA
National Provider Identifier
1568438513
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
154754 Issued in MA
Practice address
500 Faunce Corner Rd Ste 160
North Dartmouth, MA 02747-1277
Phone
(508) 973-1230
Fax
(508) 973-1245
NPI assigned
Feb 28, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 154754 MA Primary

Addresses

Primary practice location

500 Faunce Corner Rd Ste 160
North Dartmouth, MA 02747-1277

Mailing address

200 Mill Rd
Suite 180
Fairhaven, MA 02719-5252
Phone (508) 973-2000

Other identifiers 1

IdentifierTypeStateIssuer
110060148AMedicaidMA

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address atreadup18670@direct.southcoast.org

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20100901000945 MA Practitioner - Family Practice 9032278577 Reassigns benefits to 1 organization
I20231215002781 RI Practitioner - Family Practice 9032278577 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
154754MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Physicians Group, Inc. CurrentSince Jun 1, 2014 Accepting new patients
Southcoast Physicians Group, Inc. Family Medicine CurrentSince Jun 1, 2014 Accepting new patients
Southcoast Physicians Group, Inc. Past Accepting new patients

Locations

200 Mill Rd
Ste 180
Fairhaven, MA 02719
Phone (508) 973-2000

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

275 Allen St
New Bedford, MA 02740
Phone (508) 992-9167

4543 Acushnet Ave
New Bedford, MA 02745
Phone (508) 998-0003

4543 Acushnet Ave
Ste 3
New Bedford, MA 02745
Phone (508) 998-0003

500 Faunce Corner Rd
Ste 160
North Dartmouth, MA 02747
Phone (508) 973-1230

11 Friendship St
Newport, RI 02840
Phone (401) 845-1110

2444 E Main Rd
Portsmouth, RI 02871
Phone (401) 683-4817

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1141084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1568438513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL RD",
            "address_2": "SUITE 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": "500 FAUNCE CORNER RD STE 160",
            "city": "NORTH DARTMOUTH",
            "state": "MA",
            "postal_code": "027471277",
            "telephone_number": "508-973-1230",
            "fax_number": "508-973-1245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TREADUP",
        "first_name": "ANNE MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-28",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "154754",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110060148A",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "atreadup18670@direct.southcoast.org",
            "affiliation": "N",
            "endpointDescription": "Southcoast Health Epic Direct Address",
            "address_1": "500 Faunce Corner Rd Ste 160",
            "city": "North Dartmouth",
            "state": "MA",
            "country_code": "US",
            "postal_code": "027471277",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in North Dartmouth, MA

Sources for this page

Verify at the official NPI Registry.