NPIMap

Organization Active NPI

Suburban Internal Medicine, Inc.

  • Internal Medicine Physician
  • Lee, MA
National Provider Identifier
1659381192
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
55555 Issued in MA
Legal business name
SUBURBAN INTERNAL MEDICINE, INC.
Practice address
710 Stockbridge Rd
Lee, MA 01238-9316
Phone
(413) 243-0122
Fax
(413) 243-2251
NPI assigned
Aug 8, 2006
Last updated
Sep 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Laurie Mitchell
Title
Office Manager
Phone
(413) 243-0122

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 205153 MA
Internal Medicine Physician 207R00000X 160149 MA
Internal Medicine Physician 207R00000X 152983 MA
Internal Medicine Physician 207R00000X 55555 MA Primary

Addresses

Primary practice location

710 Stockbridge Rd
Lee, MA 01238-9316

Mailing address

PO Box 709
710 Stockbridge Rd
Lee, MA 01238-0709
Phone (413) 243-0122

Other identifiers 1

IdentifierTypeStateIssuer
9702351MedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050607000312 MA Part B Supplier - Clinic/Group Practice 0547203929 Receives reassigned benefits from 15 practitioners
Practice locations: Lee, MA

National Provider Directory

National Provider Directory

Locations

710 Stockbridge Rd
Lee, MA 01238
Phone (413) 243-0122

Interoperability endpoints

  • Direct secure messaging: alyssafelver@comsub.medalliesdirect.net
  • Direct secure messaging: amycampion@comsub.medalliesdirect.net
  • Direct secure messaging: danielcohen@comsub.medalliesdirect.net
  • Direct secure messaging: gabrielnaventi@comsub.medalliesdirect.net
  • Direct secure messaging: marksnowise@comsub.medalliesdirect.net
  • Direct secure messaging: maryjanescoco@comsub.medalliesdirect.net
  • Direct secure messaging: robertholub@comsub.medalliesdirect.net
  • Direct secure messaging: robertwespiser@comsub.medalliesdirect.net
  • Direct secure messaging: thomasconsolati@comsub.medalliesdirect.net

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1659381192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 709",
            "address_2": "710 STOCKBRIDGE RD",
            "city": "LEE",
            "state": "MA",
            "postal_code": "012380709",
            "telephone_number": "413-243-0122",
            "fax_number": "413-243-2251"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 STOCKBRIDGE RD",
            "city": "LEE",
            "state": "MA",
            "postal_code": "012389316",
            "telephone_number": "413-243-0122",
            "fax_number": "413-243-2251"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUBURBAN INTERNAL MEDICINE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "413-243-0122"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "205153",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "160149",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "152983",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "55555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9702351",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lee, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.