Individual provider Active NPI

Mariann C. Padron Gleich, M.D.

  • Gastroenterology Physician
  • Leominster, MA
National Provider Identifier
1578721049
Registry record updated Jun 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
241784 Issued in MA
Practice address
105 Erdman Way
Leominster, MA 01453
Phone
(978) 466-7800
Fax
(978) 466-9333
NPI assigned
May 30, 2008
Last updated
Jun 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 241784 MA
Gastroenterology Physician 207RG0100X 241784 MA Primary

Addresses

Primary practice location

105 Erdman Way
Leominster, MA 01453

Mailing address

105 Erdman Way
Leominster, MA 01453
Phone (978) 466-7800

Other names 1

  • Mariann Coromoto Padron Gleich Other name

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
I20100811000379 MA Practitioner - GastroenterologyPractitioner - Internal Medicine 2466586557 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Worcester Gastroenterology, P.C.Group PAC ID 7113069899, 4 clinicians

Practice addresses (Care Compare)

105 Erdman Way
Leominster, MA 01453-1805
Phone (978) 466-7800

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

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy315
Upper gastrointestinal (GI) endoscopy for acid reflux134

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
241784MAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
North Worcester Gastroenterology, P.C. Gastroenterology CurrentSince Aug 1, 2021 Accepting new patients

Locations

105 Erdman Way
Leominster, MA 01453
Phone (978) 466-7800

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.

Hospital & facility affiliations 3

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": "1212105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655683200000",
    "number": "1578721049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 ERDMAN WAY",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "01453",
            "telephone_number": "978-466-7800",
            "fax_number": "978-466-9333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 ERDMAN WAY",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "01453",
            "telephone_number": "978-466-7800",
            "fax_number": "978-466-9333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PADRON GLEICH",
        "first_name": "MARIANN",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-30",
        "last_updated": "2022-06-20",
        "certification_date": "2022-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "241784",
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "MA",
            "license": "241784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARIANN",
            "last_name": "PADRON GLEICH",
            "middle_name": "COROMOTO",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Leominster, MA

Sources for this page

Verify at the official NPI Registry.