NPIMap

Individual provider Active NPI

Rebecca Wallach, DO

  • Family Medicine Physician
  • Tewksbury, MA
National Provider Identifier
1578026316
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
292633 Issued in MA
Practice address
2345 Main St
Tewksbury, MA 01876-3125
Phone
(978) 658-9931
Fax
(978) 694-0991
NPI assigned
Apr 9, 2019
Last updated
Aug 1, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

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 292633 MA Primary

Addresses

Primary practice location

2345 Main St
Tewksbury, MA 01876-3125

Mailing address

2345 Main St
Tewksbury, MA 01876-3125
Phone (978) 658-9931

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
I20220908002444 MA Practitioner - Family Practice 1658755707 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physiotherapy Associates IncGroup PAC ID 3577470442, 1,432 clinicians

Practice addresses (Care Compare)

15 Railroad Ave
South Hamilton, MA 01982-2218
Phone (978) 468-7381

3119 Cranberry Hwy
Suite 5
East Wareham, MA 02538-4840
Phone (508) 759-5411

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Lahey Health Primary Care, Inc. CurrentSince Dec 1, 2024 Accepting new patients
Winchester Physician Associates, Inc Family Medicine CurrentSince Sep 26, 2022 Accepting new patients
Beth Israel Lahey Health Primary Care Inc CurrentSince Dec 1, 2024 Accepting new patients
Winchester Physician Associates Past Accepting new patients
Beth Israel Lahey Health Primary Care, Inc. Past Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8085

203 Main St
North Reading, MA 01864
Phone (978) 664-1990

15 Railroad Ave
South Hamilton, MA 01982
Phone (978) 468-7381

2345 Main St
Tewksbury, MA 01876
Phone (978) 658-9931

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10729/brand/1/csg/1/fhir/r4
  • FHIR API: https://fhir.laheyhealth.org/proxy-prd-fhir/api/FHIR/R4/

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 10

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": "1554768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1578026316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 MAIN ST",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018763125",
            "telephone_number": "978-658-9931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2345 MAIN ST",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018763125",
            "telephone_number": "978-658-9931",
            "fax_number": "978-694-0991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACH",
        "first_name": "REBECCA",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-04-09",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "292633",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tewksbury, MA

Sources for this page

Verify at the official NPI Registry.