NPIMap

Individual provider Active NPI

Prathima Chaloori, MD

  • Family Medicine Physician
  • Andover, MA
National Provider Identifier
1760444137
Registry record updated Jan 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
4301079051 Issued in MI
Practice address
140 Haverhill St
Andover, MA 01810-1550
Phone
(978) 269-0030
Fax
(978) 269-0020
NPI assigned
Apr 3, 2006
Last updated
Jan 15, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 4301079051 MI Primary

Addresses

Primary practice location

140 Haverhill St
Andover, MA 01810-1550

Mailing address

140 Haverhill St
Andover, MA 01810-1550
Phone (978) 269-0030

Other identifiers 2

IdentifierTypeStateIssuer
4688969MedicaidMI
4688978MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110921000326 MA Practitioner - Family Practice 5193789832 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Revere Medical of Massachusetts PCGroup PAC ID 0749715795, 113 clinicians

Practice addresses (Care Compare)

62 Brown St
Suite 200
Haverhill, MA 01830-6790
Phone (978) 478-5058

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
4301079051MIMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Revere Medical of Massachusetts, PC Family Medicine CurrentSince Feb 21, 2024 Accepting new patients
Steward Medical Group, Inc CurrentSince Sep 1, 2011 Accepting new patients
Steward Medical Group, Inc CurrentSince Sep 1, 2011 Accepting new patients
Steward Medical Group Inc. Past Accepting new patients
Grace Health, Inc. PastSince Jan 1, 1990 Accepting new patients

Locations

140 Haverhill St
Andover, MA 01810
Phone (978) 470-1616

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

77 Warren St
Fl 5
Brighton, MA 02135
Phone (617) 254-3376

1 Pearl St
Ste 1000
Brockton, MA 02301
Phone (508) 897-6050

15 Payson Rd
Ste 3
Foxboro, MA 02035
Phone (508) 772-1438

62 Brown St
Ste 200
Haverhill, MA 01830
Phone (978) 478-5058

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

203 Turnpike St
Ste 300
North Andover, MA 01845
Phone (978) 269-0030

Interoperability endpoints

  • Direct secure messaging: prathima.chaloori.1@32866.direct.athenahealth.com

Organizations & group practices 5

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.

Hospital & facility affiliations 9

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": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358208000000",
    "number": "1760444137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 HAVERHILL ST",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018101550",
            "telephone_number": "978-269-0030",
            "fax_number": "978-269-0020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 HAVERHILL ST",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018101550",
            "telephone_number": "978-269-0030",
            "fax_number": "978-269-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHALOORI",
        "first_name": "PRATHIMA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-03",
        "last_updated": "2013-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301079051",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4688969",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4688978",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Andover, MA

Sources for this page

Verify at the official NPI Registry.