Individual provider Active NPI

Marcelo Bogliolo P Siqueira, M.D.

  • Orthopaedic Surgery Physician
  • Plymouth, MA
National Provider Identifier
1790164978
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
286040 Issued in MA
Practice address
46 Obery St Ste 100
Plymouth, MA 02360-2237
Phone
(508) 210-5800
Fax
(508) 210-5860
NPI assigned
May 21, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207X00000X 286040 MA Primary
Orthopaedic Surgery Physician 207X00000X 57025162 OH

Addresses

Primary practice location

46 Obery St Ste 100
Plymouth, MA 02360-2237

Mailing address

46 Obery St Ste 100
Plymouth, MA 02360-2237
Phone (508) 210-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, 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
I20200708002357 PA Practitioner - Orthopedic Surgery 7719280510 Reassigns benefits to 1 organization
I20210804001628 MA Practitioner - Orthopedic Surgery 7719280510 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jordan Physician Associates IncGroup PAC ID 1254321086, 166 clinicians
Physiotherapy Associates IncGroup PAC ID 3577470442, 1,432 clinicians

Practice addresses (Care Compare)

275 Sandwich St
Plymouth, MA 02360-2183
Phone (508) 746-2000

3119 Cranberry Hwy
East Wareham, MA 02538-4840
Phone (508) 759-5411

46 Obery St
Plymouth, MA 02360-2237
Phone (508) 210-5920

860 Route 134
South Dennis, MA 02660-2577
Phone (508) 385-4212

Hospital & facility affiliations

  • Bayada Home Health Care Inc Home health agency, Plymouth, MA, CCN 227537
  • Metrowest Homecare and Hospice, an Amedisys Company Home health agency, Marlborough, MA, CCN 227050
  • Vna of Cape Cod Home health agency, South Dennis, MA, CCN 227067
  • Centerwell Home Health Home health agency, Sandwich, MA, CCN 227426
  • Bayada Home Health Care , Inc Home health agency, Hyannis, MA, CCN 227466
  • Beth Israel Deaconess Hospital Plymouth Hospital, Plymouth, MA, CCN 220060
  • Cape Cod Hospital Hospital, Hyannis, MA, CCN 220012
  • Southcoast Hospitals Group Hospital, Fall River, MA, CCN 220074
  • Spaulding Rehabilitation Hospital - Cape Cod Inpatient rehabilitation facility, East Sandwich, MA, CCN 223032

Procedures performed for Medicare patients

ProcedureNumber of procedures
Hip replacement90
Knee replacement77
Removal of tissue1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Reconstructive Orthopaedic Associates II LLC Single Specialty CurrentSince Aug 1, 2020 Accepting new patients
Jordan Physician Associates, Inc. Single Specialty CurrentSince Jun 1, 2024 Accepting new patients
Reconstructive Orthopaedic Associates II LLC Orthopaedic Surgery CurrentSince Aug 1, 2020 Accepting new patients
Jordan Physician Associates, Inc. Single Specialty CurrentSince Jun 1, 2024 Accepting new patients
Plymouth Bay Orthopedic Associates Inc. Single Specialty CurrentSince Sep 1, 2021 Accepting new patients
Beth Israel Deaconess Hospital Plymouth, Inc. Past Accepting new patients

Locations

95 Tremont St
Ste 1
Duxbury, MA 02332
Phone (781) 934-2400

8 Commerce Blvd
Middleboro, MA 02346
Phone (774) 260-9300

46 Obery St
Plymouth, MA 02360
Phone (508) 210-5920

41 Resnik Rd
Plymouth, MA 02360
Phone (781) 934-2400

46 Obery St
Ste 100
Plymouth, MA 02360
Phone (508) 746-0284

290 Route 130
Sandwich, MA 02563
Phone (508) 833-2255

999 Route 73 N
Ste 401
Marlton, NJ 08053

327 Greentree Rd
Sewell, NJ 08080
Phone (856) 286-4224

833 Chestnut St
Ste 520
Philadelphia, PA 19107
Phone (267) 592-6191

925 Chestnut St
Fl 5
Philadelphia, PA 19107
Phone (267) 339-3738

Interoperability endpoints

  • Direct secure messaging: msiqueira253028@direct.bilh.masshiway.net

Organizations & group practices 7

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": "1432166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1790164978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 OBERY ST STE 100",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602237",
            "telephone_number": "508-210-5800",
            "fax_number": "508-210-5860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 OBERY ST STE 100",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602237",
            "telephone_number": "508-210-5800",
            "fax_number": "508-210-5860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIQUEIRA",
        "first_name": "MARCELO",
        "middle_name": "BOGLIOLO P",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-05-21",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "MA",
            "license": "286040",
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "OH",
            "license": "57025162",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.