Individual provider Active NPI

Melissa Colbert

  • Physical Medicine & Rehabilitation Physician
  • Charlestown, MA
National Provider Identifier
1720372931
Registry record updated Dec 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
251267 Issued in MA
Practice address
300 1St Ave
Charlestown, MA 02129-3109
Phone
(617) 952-5243
Fax
(617) 952-5934
NPI assigned
Jun 6, 2011
Last updated
Dec 19, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 19, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 251267 MA Primary

Addresses

Primary practice location

300 1St Ave
Charlestown, MA 02129-3109

Mailing address

300 1St Ave
Charlestown, MA 02129-3109

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150923000763 MA Practitioner - Family PracticePractitioner - Peripheral Vascular Disease 1355594581 Reassigns benefits to 3 organizations
I20220222002581 MA Practitioner - Physical Medicine and Rehabilitation 1355594581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
University of Connecticut School of Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Myomedicine, LLCGroup PAC ID 4385038066, 5 clinicians

Practice addresses (Care Compare)

90 Conz St
Northampton, MA 01060-3881
Phone (413) 320-4811

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
251267MAMDPediatric Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Sep 10, 2015 Accepting new patients
Vohra Post Acute Care Physicians of the Northeast PA Family Medicine CurrentSince Sep 4, 2017 Accepting new patients
Myomedicine, LLC Physical Medicine & Rehabilitation CurrentSince Dec 15, 2021 Accepting new patients
Massachusetts General Physicians Organization Inc Physical Medicine & Rehabilitation CurrentSince Sep 10, 2015 Accepting new patients

Locations

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

300 1st Ave
Charlestown, MA 02129
Phone (617) 952-5000

945 Concord St
Framingham, MA 01701
Phone (203) 598-6045

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

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1307318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576713600000",
    "number": "1720372931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 1ST AVE",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021293109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 1ST AVE",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021293109",
            "telephone_number": "617-952-5243",
            "fax_number": "617-952-5934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLBERT",
        "first_name": "MELISSA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-06",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MA",
            "license": "251267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlestown, MA

Sources for this page

Verify at the official NPI Registry.