Serge D Botsaris, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

78476 Issued in MA

Practice address

100 Century Dr
Worcester, MA 01606-1244

Phone

(844) 319-0000

Fax

(774) 701-0950

NPI assigned

May 24, 2006

Last updated

Dec 29, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

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

Specialty

Psychiatry

Education

Tufts University School of Medicine, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

T Massachusetts, LLCGroup PAC ID 6901159003, 20 clinicians

Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Marlborough Hospital Hospital, Marlborough, MA, CCN 220049
• Umass Memorial Medical Center/University Campus Hospital, Worcester, MA, CCN 220163

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as apm

Quality

82.98

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sbotsaris22249@umassmemorial.direct-ci.com

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.

• T Massachusetts, LLC

  dba Hospital for Behavioral Medicine

  • Psychiatric Hospital
  • Worcester, MA
  • NPI 1346728748
  Medicare reassignment Care Compare group NPD
• Umass Memorial Medical Group Inc

  • Internal Medicine Physician
  • Worcester, MA
  • NPI 1760445373

  Psychiatry

  Medicare reassignment Care Compare group NPD
• St. Vincent Psychiatry Associates

  • Psychiatry Physician
  • Worcester, MA
  • NPI 1992881288
  NPD (past) Authorized official
• Umass Memorial Medical Group, Inc.

  dba Urgent Care Express at Harrington

  • Urgent Care Clinic/Center
  • Oxford, MA
  • NPI 1982381018
  NPD
• University of Massachusetts

  dba UMass Medical School

  • Professional Counselor
  • Worcester, MA
  • NPI 1477618957
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Marlborough Hospital Corp

  dba Marlborough Hospital

  • Registered Dietitian
  • Marlborough, MA
  • NPI 1104488170

  Hospital

  Care Compare affiliation Name & address match
• Umass Memorial Medical Center, Inc.

  • General Acute Care Hospital
  • Worcester, MA
  • NPI 1831151455
  Care Compare affiliation

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609200000000",
    "number": "1679528095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CENTURY DR",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016061244",
            "telephone_number": "844-319-0000",
            "fax_number": "774-701-0950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOTSARIS",
        "first_name": "SERGE",
        "middle_name": "D",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-24",
        "last_updated": "2020-12-29",
        "certification_date": "2020-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "78476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sbotsaris22249@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "100 Century Dr",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016061244",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "100 Century Dr",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016061244",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Chloe Botelho
• Rachel M Botelho
• Cameron Both, MD
• Naomi F Botkin, M.D.
• Mina Botros, MD
• Benjamin Wise Botsford, M.D.
• Kaoutar Bouaitah
• Dominica Boucher
• Erin Boucher
• Jacalyn Corrine Boucher, CLINICIAN

• Psychiatry Physician in Worcester, MA
• Providers in Worcester, MA by specialty
• Psychiatry Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.