Rupenkumar Pravin Amin, M.D.

Individual provider Active NPI Critical Care Medicine (Internal Medicine) Physician · Concord, MA

NPI 1568625820 · NPPES record last updated Oct 5, 2021

Key facts

NPI
1568625820
Entity type
Individual (NPI type 1)
Primary specialty
Critical Care Medicine (Internal Medicine) Physician 207RC0200X
License
#254653 (MA)
Practice address
133 Old Road to Nine Acre Corner
Concord, MA 01742
Phone
(978) 466-4396
Fax
(978) 466-4029
NPI assigned
Jul 8, 2008
Sex
Male
Sole proprietor
No

Organizations & group practices 7

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 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Critical Care (Intensivists)
Also: Pulmonary Disease
Education
Wake Forest University School of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ccmma SC LLC (17 clinicians)

Practice addresses (Care Compare)

27 Henderson St
Arlington, MA 02474-5507
Phone (845) 702-2711

9717 E Sector Dr
Mesa, AZ 85212-1119
Phone (845) 702-2711

Hospital & facility affiliations

  • Shasta Regional Medical Center Hospital · Redding, CA · CCN 050764
  • Marshall Medical Center Hospital · Placerville, CA · CCN 050254

Medicare participation

Medicare fee-for-service enrollment
Enrolled (2 enrollments) in MA, AZ
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20140401000837 MA Practitioner - Critical Care (Intensivists)
Practitioner - Pulmonary Disease
7810058237 Reassigns benefits to 3 organizations
I20250930003819 AZ Practitioner - Critical Care (Intensivists)
Practitioner - Pulmonary Disease
7810058237 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
#254653MAMDPulmonary Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emerson Practice Associates, Inc. Internal Medicine Current
since Nov 1, 2017
Accepting new patients
Mass Lung & Allergy, PC. Critical Care Medicine Current
since Nov 1, 2015
Accepting new patients
Ccmma SC LLC Critical Care Medicine Current
since Jul 1, 2022
Accepting new patients
Indiana Hospitalists, PC Internal Medicine Past Accepting new patients
St. Francis Medical Group, LLC Family Medicine Past Accepting new patients
Pulmonary Specialist Group of Nevada Critical Care Medicine Past Accepting new patients
Community Neuroscience Services, LLC Past
since May 25, 2021
Accepting new patients

Locations

1100 Butte St
Redding, CA 96001
Phone (530) 227-6361

133 Ornac
Concord, MA 01742
Phone (978) 287-3000

100 Hospital Rd
Ste 2A
Leominster, MA 01453
Phone (978) 466-2692

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

48 Nelson St
Leominster, MA 01453
Phone (978) 466-4396

159 Union St
Ste 102
Marlborough, MA 01752
Phone (508) 481-0610

120 N Delaware St
Sandusky, MI 48471
Phone (810) 648-3770

350 Boulevard
Passaic, NJ 07055
Phone (973) 365-4300

425 W 5th St
East Liverpool, OH 43920
Phone (330) 385-7200

6565 Fannin St
Va Hospital, TX 77030
Phone (713) 394-6000

Interoperability endpoints

  • Direct secure messaging: ramin4083380@oc.providencedirect.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/IJCCDA

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X #254653 MA
Pulmonary Disease Physician 207RP1001X #254653 MA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X #254653 MA Yes

Addresses

Primary practice location

133 Old Road to Nine Acre Corner
Concord, MA 01742

Mailing address

133 Old Road to 9 Acre Cor
Concord, MA 01742-4159
Phone (978) 341-8660

Other practice location 1

759 Chestnut St # S4429
Springfield, MA 01199-1001
Phone (413) 794-5439

Other providers in Concord, MA

All providers in Concord, MA · Critical Care Medicine (Internal Medicine) Physician in Massachusetts

Sources for this page

Verify at the official NPI Registry.