Classic Healthcare Medical Group LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

205080 Issued in MA

Legal business name

CLASSIC HEALTHCARE MEDICAL GROUP LLC

Practice address

300 Chestnut St
Ste 1400
Needham, MA 02492-2497

Phone

(781) 559-0230

Fax

(781) 559-0231

NPI assigned

Jan 5, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Steven Van Dam, M.D.NPI 1447206214

Title

Medical Director

Phone

(781) 559-0230

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 1

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

• Steven H Van Dam, MD

  • Internal Medicine Physician
  • Needham, MA
  • NPI 1447206214
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1388880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1388880000000",
    "number": "1649691957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CHESTNUT ST",
            "address_2": "STE 1400",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024922497",
            "telephone_number": "781-559-0230",
            "fax_number": "781-559-0231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CHESTNUT ST",
            "address_2": "STE 1400",
            "city": "NEEDHAM",
            "state": "MA",
            "postal_code": "024922497",
            "telephone_number": "781-559-0230",
            "fax_number": "781-559-0231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLASSIC HEALTHCARE MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-05",
        "last_updated": "2014-01-05",
        "status": "A",
        "authorized_official_last_name": "VAN DAM",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "781-559-0230",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "205080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Michael Ciccone, M.D.
• Marissa Ann Cieri
• Lori Grossman Ciotti, LICSW
• Sandra Cisternelli
• Janelle Clarke, BCBA
• Alan Edward Clayman, DPM
• Clear Steps Recovery Ma Corp.
• Jennifer Cleary, MS, OTR/L
• Matthew Raymond Clements, LMHC
• Molly Alexandra Cleveland, M.S. CCC-SLP

• Internal Medicine Physician in Needham, MA
• Providers in Needham, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.