Individual provider Active NPI

Tanzeem Alam

  • Adult Health Nurse Practitioner
  • Lynnfield, MA
National Provider Identifier
1821773136
Registry record updated Aug 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN2348703 Issued in MA
Practice address
1350 Market St
Lynnfield, MA 01940-4048
Phone
(781) 213-4050
NPI assigned
Jun 15, 2023
Last updated
Aug 11, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN2348703 MA
Adult Health Nurse Practitioner 363LA2200X RN2348703 MA Primary

Addresses

Primary practice location

1350 Market St
Lynnfield, MA 01940-4048

Mailing address

1350 Market St
Lynnfield, MA 01940-4048

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230825002225 MA Practitioner - Nurse Practitioner 8921461781 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Riverbend Medical Group IncGroup PAC ID 5698064343, 227 clinicians

Practice addresses (Care Compare)

175 Carew St
Suite 200
Springfield, MA 01104-2391
Phone (413) 734-8254

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN2348703MAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Riverbend Medical Group, Inc CurrentSince Jan 8, 2024 Accepting new patients
Riverbend Medical Group, Inc. CurrentSince Jan 8, 2024 Accepting new patients
Beth Israel Lahey Health Primary Care, Inc. PastSince Jun 18, 2023 Accepting new patients
Beverly Radiology Associates, Inc. PastSince Jun 18, 2023 Accepting new patients

Locations

175 Carew St
Ste 200
Springfield, MA 01104
Phone (413) 734-8254

271 Carew St
Springfield, MA 01104
Phone (413) 748-9000

Interoperability endpoints

  • Direct secure messaging: talam3112066@direct.trinity-health.org

Organizations & group practices 4

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 2

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": "1686787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691712000000",
    "number": "1821773136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 MARKET ST",
            "city": "LYNNFIELD",
            "state": "MA",
            "postal_code": "019404048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 MARKET ST",
            "city": "LYNNFIELD",
            "state": "MA",
            "postal_code": "019404048",
            "telephone_number": "781-213-4050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALAM",
        "first_name": "TANZEEM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-15",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2348703",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MA",
            "license": "RN2348703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnfield, MA

Sources for this page

Verify at the official NPI Registry.