NPIMap

Organization Active NPI

Myomedicine, LLC

  • Physical Medicine & Rehabilitation Physician
  • Northampton, MA
National Provider Identifier
1609534346
Registry record updated Nov 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
MYOMEDICINE, LLC
Practice address
90 Conz St
Northampton, MA 01060-3881
Phone
(413) 320-4811
NPI assigned
Nov 30, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2021

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

Authorized official

Name
Dr. Melissa Colbert, MDNPI 1720372931
Title
Medical Director
Phone
(413) 320-4811

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

90 Conz St
Northampton, MA 01060-3881

Mailing address

24 Old Long Plain Rd
Leverett, MA 01054-9519
Phone (413) 320-4811

Other identifiers 1

IdentifierTypeStateIssuer
1720372931OtherMANPI

Other names 1

  • Myomedicine, LLC Former legal business name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220222002544 MA Part B Supplier - Clinic/Group Practice 4385038066 Receives reassigned benefits from 6 practitioners
Practice locations: Northampton, MA

National Provider Directory

National Provider Directory

Locations

90 Conz St
Northampton, MA 01060
Phone (413) 320-4811

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1638230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638230400000",
    "number": "1609534346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 OLD LONG PLAIN RD",
            "city": "LEVERETT",
            "state": "MA",
            "postal_code": "010549519",
            "telephone_number": "413-320-4811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 CONZ ST",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "010603881",
            "telephone_number": "413-320-4811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYOMEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-30",
        "last_updated": "2021-11-30",
        "certification_date": "2021-11-30",
        "status": "A",
        "authorized_official_last_name": "COLBERT",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "413-320-4811",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1720372931",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Myomedicine, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Northampton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.