CVS Clinic Primary Care PLLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

CVS CLINIC PRIMARY CARE PLLC

Practice address

21 Austin St
Charlestown, MA 02129-3502

Phone

(401) 855-8327

NPI assigned

May 10, 2024

Organization subpart

Yes

Parent organization

CVS CLINIC PLLCAs reported in NPPES

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

Authorized official

Name

Deborah Pincince

Title

Administrator

Phone

(401) 855-8327

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• CVS Clinic Primary Care PLLC

  • Multi-Specialty Clinic/Center
  • Swampscott, MA
  • NPI 1366206955

  O20241119000406

  Same enrollment
• CVS Clinic Primary Care PLLC

  • Multi-Specialty Clinic/Center
  • Beverly, MA
  • NPI 1629832225

  O20241119000406

  Same enrollment

Part of

CVS Clinic PLLC

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• CVS Clinic PLLC

  • Family Nurse Practitioner
  • Swampscott, MA
  • NPI 1306623426
  NPPES parent name

Practitioners 6

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

• Barry A Ehrlich, M.D.

  • Internal Medicine Physician
  • Waltham, MA
  • NPI 1710934047
  NPD
• Kangweon Lee, FNP-BC

  • Family Nurse Practitioner
  • Beverly, MA
  • NPI 1720673544
  NPD
• James A Meyers, M.D.

  • Family Medicine Physician
  • Boston, MA
  • NPI 1952369332
  NPD
• Michael Richardson, M.D.

  • Family Medicine Physician
  • Wellesley, MA
  • NPI 1124430160
  NPD
• Rachel Catherine Scimone, AGNP-BC

  • Nurse Practitioner
  • Reading, MA
  • NPI 1962289058
  NPD
• Raksa Chet Son, PA-C

  • Physician Assistant
  • Lowell, MA
  • NPI 1306471628
  NPD

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

{
    "created_epoch": "1715299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1737590400000",
    "number": "1760230064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 CVS DR",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028956146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 AUSTIN ST",
            "city": "CHARLESTOWN",
            "state": "MA",
            "postal_code": "021293502",
            "telephone_number": "401-855-8327"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CVS CLINIC PRIMARY CARE PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CVS CLINIC PLLC",
        "enumeration_date": "2024-05-10",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-23",
        "status": "A",
        "authorized_official_last_name": "PINCINCE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "401-855-8327"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Craig S. Tenzer, M.D., D.P.M., P.C. (FootMed)
• Zachary Smith Crockett, MD
• Diane P Cummings, RN
• Shelby Curran, LICSW
• Alice Coakley Currie, FNP-BC
• CVS Pharmacy Inc (CVS Pharmacy # 01009)
• Alanna Daley, AGPCNP-BC
• Daniel Daneshvar, M.D., PH.D.
• Michael Daniel Daniels, MD
• Craig Dannehl

• Multi-Specialty Clinic/Center in Charlestown, MA
• Providers in Charlestown, MA by specialty
• Multi-Specialty Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 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.