Active NPI
Michael J Terlizzi, MD
- Dermatology Physician
- Andover, MA
National Provider Identifier
1760583777
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 44184
- Practice address
- 138 Haverhill St
Suite 200
Andover, MA 01810-1509 - Phone
- (978) 475-4322
- Fax
- (978) 474-4537
- NPI assigned
- Sep 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 44184 | MA | Primary |
Addresses
Primary practice location
138 Haverhill St
Suite 200
Andover, MA 01810-1509
Mailing address
138 Haverhill St
Suite 200
Andover, MA 01810-1509
Phone (978) 475-4322
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 33476 | Other | MA | FALLON |
| 4029 | Other | MA | HARVARD |
| B18221 | Other | MA | BLUE SHIELD |
| 710419 | Other | MA | TUFTS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44184 | MA | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1760583777",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "138 HAVERHILL ST",
"address_2": "SUITE 200",
"city": "ANDOVER",
"state": "MA",
"postal_code": "018101509",
"telephone_number": "978-475-4322",
"fax_number": "978-474-4537"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "138 HAVERHILL ST",
"address_2": "SUITE 200",
"city": "ANDOVER",
"state": "MA",
"postal_code": "018101509",
"telephone_number": "978-475-4322",
"fax_number": "978-474-4537"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TERLIZZI",
"first_name": "MICHAEL",
"middle_name": "J",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MA",
"license": "44184",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FALLON",
"identifier": "33476",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD",
"identifier": "4029",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "B18221",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "710419",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Andover, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.