Individual provider Active NPI

Theo E Meyer, M.D.

  • Cardiovascular Disease Physician
  • Worcester, MA
National Provider Identifier
1568445294
Registry record updated Nov 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
150067 Issued in MA
Practice address
55 Lake Ave N
Department of Cardiovascular Medicine
Worcester, MA 01655-0002
Phone
(508) 334-3452
Fax
(774) 441-7657
NPI assigned
Nov 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Heart Failure and Transplant Cardiology Physician 207RA0001X 150067 MA
Cardiovascular Disease Physician 207RC0000X 150067 MA Primary

Addresses

Primary practice location

55 Lake Ave N
Department of Cardiovascular Medicine
Worcester, MA 01655-0002

Mailing address

PO Box 415348
Boston, MA 02241-5348

Other identifiers 2

IdentifierTypeStateIssuer
110054155AMedicaidMA
3121895MedicaidMA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address tmeyer11100@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: 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
I20080326001001 MA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Advanced Heart Failure and Transplant CardiologyPractitioner - Internal Medicine 9335119403 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Advanced Heart Failure and Transplant Cardiology
Education
Other, 1976
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)

1 W Boylston St
Worcester, MA 01605-1274
Phone (508) 854-2636

100 Century Dr
Worcester, MA 01606-1244
Phone (508) 762-5400

100 Hospital Rd
Leominster, MA 01453-2253
Phone (978) 466-4220

116 Belmont St
RM 11
Worcester, MA 01605-2964
Phone (508) 334-1102

119 Belmont St
Worcester, MA 01605-2903
Phone (508) 334-1000

151 Worcester Rd
Barre, MA 01005-9002
Phone (978) 355-6321

155 Franklin Rd
Fitchburg, MA 01420-5140
Phone (978) 345-1919

155 Union St
Marlborough, MA 01752-1228
Phone (508) 481-7390

157 Union St
Marlborough, MA 01752-1228
Phone (508) 486-5521

188 Worcester Prov Tpke
Sutton, MA 01590-1908
Phone (508) 865-3650

201 Highland St
Suite B
Clinton, MA 01510-1037
Phone (978) 368-3731

21 Eastern Ave
Worcester, MA 01605-3094
Phone (508) 856-2500

24 Julio Dr
Shrewsbury, MA 01545-3053
Phone (508) 845-1436

242 Woodland St
West Boylston, MA 01583-1670
Phone (508) 835-6221

26 Julio Dr
Shrewsbury, MA 01545-3020
Phone (508) 845-2323

275 Nichols Rd
Fitchburg, MA 01420-1919
Phone (978) 343-5048

279 Lincoln St
Worcester, MA 01605-2120
Phone (508) 334-8830

281 E Hartford Ave
Uxbridge, MA 01569-1278
Phone (508) 278-5573

281 Lincoln St
Worcester, MA 01605-2138
Phone (508) 334-1000

291 Lincoln St
Worcester, MA 01605-3643

326 Nichols Rd
Fitchburg, MA 01420-5140
Phone (978) 343-5270

328 Shrewsbury St
Worcester, MA 01604-4613
Phone (508) 757-5520

370 Lunenburg St
Fitchburg, MA 01420-4541
Phone (978) 345-1040

378 Plantation St
Worcester, MA 01605-2324
Phone (508) 334-1000

489 Washington St
Auburn, MA 01501-5709
Phone (508) 832-9646

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

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group Inc CurrentSince Mar 29, 2008 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Mar 29, 2008 Accepting new patients
Umass Memorial Medical Center, Inc. Past Accepting new patients

Locations

320 Pomfret St
Putnam, CT 06260
Phone (860) 963-6331

100 Hospital Rd
Ste 3A
Leominster, MA 01453
Phone (978) 537-9305

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Interoperability endpoints

  • Direct secure messaging: tmeyer11100@umassmemorial.direct-ci.com

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.

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": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605139200000",
    "number": "1568445294",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "address_2": "DEPARTMENT OF CARDIOVASCULAR MEDICINE",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-334-3452",
            "fax_number": "774-441-7657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER",
        "first_name": "THEO",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-28",
        "last_updated": "2020-11-12",
        "certification_date": "2020-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RA0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Advanced Heart Failure and Transplant Cardiology",
            "state": "MA",
            "license": "150067",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": "150067",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110054155A",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3121895",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tmeyer11100@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "55 Lake Ave N",
            "address_2": "Department of Cardiovascular Medicine",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016550002",
            "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": "55 Lake Ave N",
            "address_2": "Department of Cardiovascular Medicine",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016550002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.