NPIMap

Individual provider Active NPI

Deneen E. Pelletier, M.D.

  • Internal Medicine Physician
  • Cambridge, MA
National Provider Identifier
1770571671
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
77772 Issued in MA
Practice address
725 Concord Ave
Suite 4100
Cambridge, MA 02138-1040
Phone
(617) 864-8822
Fax
(617) 547-5367
NPI assigned
Oct 13, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 77772 MA Primary

Addresses

Primary practice location

725 Concord Ave
Suite 4100
Cambridge, MA 02138-1040

Mailing address

13 Copeland Dr
Bedford, MA 01730-1116
Phone (781) 271-9493

Other identifiers 1

IdentifierTypeStateIssuer
3129799MedicaidMA

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
I20050802000296 MA Practitioner - Internal Medicine 0547298457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Connecticut School of Medicine, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mount Auburn Professional Services IncGroup PAC ID 6103725031, 229 clinicians

Practice addresses (Care Compare)

300 Mount Auburn St
Cambridge, MA 02138-5600
Phone (617) 499-5055

57 Bedford St
Suite 130
Lexington, MA 02420-4543
Phone (781) 862-7500

725 Concord Ave
Suite 6100
Cambridge, MA 02138-1040
Phone (617) 864-8822

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
77772MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mount Auburn Professional Services Inc Internal Medicine CurrentSince Sep 16, 2017 Accepting new patients

Locations

725 Concord Ave
Ste 6100
Cambridge, MA 02138
Phone (617) 864-8822

725 Concord Ave
Ste 4100
Cambridge, MA 02138
Phone (617) 864-8822

57 Bedford St
Ste 130
Lexington, MA 02420
Phone (781) 484-7500

Interoperability endpoints

  • Direct secure messaging: dpelletier254169@direct.bilh.masshiway.net

Organizations & group practices 1

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 11

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": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1770571671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 COPELAND DR",
            "city": "BEDFORD",
            "state": "MA",
            "postal_code": "017301116",
            "telephone_number": "781-271-9493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 CONCORD AVE",
            "address_2": "SUITE 4100",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021381040",
            "telephone_number": "617-864-8822",
            "fax_number": "617-547-5367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLETIER",
        "first_name": "DENEEN",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-13",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "77772",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3129799",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.