NPIMap

Organization Active NPI

Infinity Treatment Centers of America LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • North Andover, MA
National Provider Identifier
1811650617
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
INFINITY TREATMENT CENTERS OF AMERICA LLC
Practice address
790 Turnpike St Ste 300
North Andover, MA 01845-6129
Phone
(678) 296-0842
Fax
(803) 932-9618
NPI assigned
Oct 19, 2021
Last updated
Nov 6, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Authorized official

Name
Moinuddin H Muttakin, MDNPI 1427158146
Title
Owner
Phone
(803) 220-2238

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary

Addresses

Primary practice location

790 Turnpike St Ste 300
North Andover, MA 01845-6129

Mailing address

790 Turnpike St Ste 300
North Andover, MA 01845-6129
Phone (678) 296-0842

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211122000562 MA Part B Supplier - Clinic/Group Practice 9436548021 Receives reassigned benefits from 7 practitioners
Practice locations: Dracut, MA; North Andover, MA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1634601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730851200000",
    "number": "1811650617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 TURNPIKE ST STE 300",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018456129",
            "telephone_number": "678-296-0842",
            "fax_number": "803-932-9618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 TURNPIKE ST STE 300",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018456129",
            "telephone_number": "678-296-0842",
            "fax_number": "803-932-9618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFINITY TREATMENT CENTERS OF AMERICA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-19",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A",
        "authorized_official_last_name": "MUTTAKIN",
        "authorized_official_first_name": "MOINUDDIN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "803-220-2238",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Andover, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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.