Pleasant Lake Medical Center LLC
Organization Active NPI Primary Care Clinic/Center · Harwich, MA
NPI 1831879501 · NPPES record last updated Jul 29, 2024
Key facts
- NPI
- 1831879501
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Primary Care Clinic/Center 261QP2300X
- Legal business name
- PLEASANT LAKE MEDICAL CENTER LLC
- Practice address
- 253 Pleasant Lake Ave Ste 100
Harwich, MA 02645-2540 - Phone
- (617) 785-2066
- NPI assigned
- Jul 19, 2023
- Organization subpart
- No
Authorized official
- Name
- Dr. Qiang Nai, MD, PHD, MPH
- Title
- President
- Phone
- (617) 785-2066
Practitioners 7
-
Warren King Russell, M.D.
-
Michael Paul Hutchinson, PA-C
-
Carol A Topolewski, M.D.
-
Qiang Nai, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20240506001497 | MA | Part B Supplier - Clinic/Group Practice | 1951741057 |
Receives reassigned benefits from 7 practitioners Practice locations: Harwich, MA |
National Provider Directory
Locations
253 Pleasant Lake Ave
Ste 100
Harwich, MA 02645
Phone (508) 432-5233
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinic/Center | 261Q00000X | |||
| Infusion Therapy Clinic/Center | 261QI0500X | |||
| Multi-Specialty Clinic/Center | 261QM1300X | |||
| Primary Care Clinic/Center | 261QP2300X | Yes | ||
| Specialty Pharmacy | 3336S0011X |
Addresses
Primary practice location
253 Pleasant Lake Ave Ste 100
Harwich, MA 02645-2540
Mailing address
253 Pleasant Lake Ave Ste 100
Harwich, MA 02645-2540
Phone (508) 274-4991
Other providers in Harwich, MA
- Lindsay Pepin
- Peter M McKay MD PC
- Dina Peterson Qualter
- Pleasant Lake Cancer Center LLC
- Pleasant Lake Management Company PC
- Pleasant Lake Urgent Care LLC
- Prism Medical Associates,LLC
- Mary Peyton Provenzano
- Robert E. Reed Jr.
- Marilyn Hyland Reedy
All providers in Harwich, MA · Primary Care Clinic/Center in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.