Individual provider Active NPI

Christopher Michael Mashiak, MD

  • Emergency Medicine Physician
  • Lebanon, NH
National Provider Identifier
1699235879
Registry record updated May 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
70667 Issued in CT
Practice address
1 Medical Center Dr
Lebanon, NH 03756-1000
Phone
(603) 653-0400
NPI assigned
Mar 22, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Emergency Medicine Physician 207P00000X 70667 CT Primary

Addresses

Primary practice location

1 Medical Center Dr
Lebanon, NH 03756-1000

Mailing address

129 Whitney St Apt 2
Hartford, CT 06105-2268
Phone (860) 306-6466

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20220606002202 CT Practitioner - Emergency Medicine 7719212885 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
University of Connecticut School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Emergency Medicine Specialists LLCGroup PAC ID 8729157797, 34 clinicians

Practice addresses (Care Compare)

71 Haynes St
Manchester, CT 06040-4131
Phone (860) 646-1222

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.01 of 100Reported as group
Quality
71.79
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
70667CTMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Emergency Medicine Specialists, LLC Emergency Medicine CurrentSince Dec 27, 2022 Accepting new patients
Nems PLLC Emergency Medicine CurrentSince Dec 15, 2024 Accepting new patients
Emergency Care Services of Connecticut, P.C. Emergency Medicine CurrentSince May 1, 2022 Accepting new patients

Locations

71 Haynes St
Manchester, CT 06040
Phone (860) 533-2981

435 Lewis Ave
Meriden, CT 06451
Phone (203) 284-1340

320 Pomfret St
Putnam, CT 06260
Phone (860) 963-6331

81 Meriden Ave
Southington, CT 06489
Phone (860) 224-5540

31 Union St
Vernon Rockvl, CT 06066
Phone (860) 289-6451

64 Robbins St
Waterbury, CT 06708
Phone (203) 573-7142

112 Mansfield Ave
Willimantic, CT 06226
Phone (830) 423-6410

Interoperability endpoints

  • Direct secure messaging: christopher.mashiak@xdr.hhchealthdirect.org

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

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": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653436800000",
    "number": "1699235879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 WHITNEY ST APT 2",
            "city": "HARTFORD",
            "state": "CT",
            "postal_code": "061052268",
            "telephone_number": "860-306-6466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 MEDICAL CENTER DR",
            "city": "LEBANON",
            "state": "NH",
            "postal_code": "037561000",
            "telephone_number": "603-653-0400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASHIAK",
        "first_name": "CHRISTOPHER",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-22",
        "last_updated": "2022-05-25",
        "certification_date": "2022-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CT",
            "license": "70667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lebanon, NH

Sources for this page

Verify at the official NPI Registry.