Alice McCormick Abbott, MD
Individual provider Active NPI Endocrinology, Diabetes & Metabolism Physician · Leeds, MA
NPI 1922096205 · NPPES record last updated Jul 23, 2010
Key facts
- NPI
- 1922096205
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician 207RE0101X
- License
- 78634 (MA)
- Practice address
- 421 N Main St
Leeds, MA 01053-9764 - Phone
- (413) 584-4040
- Fax
- (413) 773-8435
- NPI assigned
- Oct 11, 2005
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151207002548 | MA | Order and Referring Only - Endocrinology |
6103855606 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 78634 | MA | MD | Endocrinology, Diabetes & Metabolism Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Connecticut River Internists, LLP | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | 78634 | MA | Yes |
Addresses
Primary practice location
421 N Main St
Leeds, MA 01053-9764
Mailing address
421 North Main
Leeds, MA 01053
Phone (413) 584-4040
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3141691 | Medicaid | MA | |
| J31132 | Other | BCBS |
Other names
- Alice Gwyn McCormick
Other providers in Leeds, MA
All providers in Leeds, MA · Endocrinology, Diabetes & Metabolism Physician 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 23, 2010. 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.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.