NPIMap

Individual provider Active NPI

Mithun S. Nallari, M.D.

  • Internal Medicine Physician
  • Woburn, MA
National Provider Identifier
1902130891
Registry record updated Mar 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
243569 Issued in MA
Practice address
23 Warren Avenue
Suite #100
Woburn, MA 01801-4979
Phone
(781) 933-1198
Fax
(781) 933-9246
NPI assigned
Sep 24, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 241559 MA
Internal Medicine Physician 207R00000X 243569 MA Primary

Addresses

Primary practice location

23 Warren Avenue
Suite #100
Woburn, MA 01801-4979

Mailing address

P.O. Box 760
Winchester, MA 01890-4260
Phone (781) 756-7273

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
I20110413000119 MA Practitioner - Internal Medicine 1557545738 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Warren Alpert Medical School of Brown University, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

15 Railroad Ave
South Hamilton, MA 01982-2218
Phone (978) 468-7381

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
241559MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Lahey Health Primary Care Inc CurrentSince Dec 1, 2024 Accepting new patients
Beth Israel Lahey Health Primary Care, Inc. Internal Medicine CurrentSince Dec 1, 2024 Accepting new patients
Winchester Physician Associates, Inc Internal Medicine CurrentSince Apr 1, 2011 Accepting new patients
Winchester Physician Associates Internal Medicine Past Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

203 Main St
North Reading, MA 01864
Phone (978) 664-1990

15 Railroad Ave
South Hamilton, MA 01982
Phone (978) 468-7381

41 Highland Ave
Winchester, MA 01890
Phone (781) 756-2000

23 Warren Ave
Ste 100
Woburn, MA 01801
Phone (781) 933-1198

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/10729/brand/1/csg/1/fhir/r4
  • Direct secure messaging: mnallari23123@direct.bilh.masshiway.net

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 and National Provider Directory roles.

Hospital & facility affiliations 9

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": "1253750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1298937600000",
    "number": "1902130891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 760",
            "city": "WINCHESTER",
            "state": "MA",
            "postal_code": "018904260",
            "telephone_number": "781-756-7273",
            "fax_number": "781-721-0725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23 WARREN AVENUE",
            "address_2": "SUITE #100",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018014979",
            "telephone_number": "781-933-1198",
            "fax_number": "781-933-9246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NALLARI",
        "first_name": "MITHUN",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-09-24",
        "last_updated": "2011-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "241559",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "243569",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

Verify at the official NPI Registry.