Individual provider Active NPI

Emelyn Borja Molato, M.D.

  • Family Medicine Physician
  • Tewksbury, MA
National Provider Identifier
1922326529
Registry record updated Mar 30, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
255142 Issued in MA
Practice address
600 Clark Rd
Suite 3
Tewksbury, MA 01876-1699
Phone
(978) 851-4141
Fax
(978) 788-7911
NPI assigned
May 7, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MT196661 PA
Family Medicine Physician 207Q00000X 255142 MA Primary

Addresses

Primary practice location

600 Clark Rd
Suite 3
Tewksbury, MA 01876-1699

Mailing address

600 Clark Rd
Suite 3
Tewksbury, MA 01876-1699
Phone (978) 851-4141

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130912000144 MA Practitioner - Family Practice 1951545029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
LGH Medical Group, Inc.Group PAC ID 3173626751, 165 clinicians

Practice addresses (Care Compare)

295 Varnum Ave
Lowell, MA 01854-2134
Phone (978) 788-7344

600 Clark Rd
Tewksbury, MA 01876-1699
Phone (978) 851-4141

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT196661PAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
LGH Medical Group, Inc. Family Medicine CurrentSince Aug 1, 2013 Accepting new patients
LGH Professional Services LLC Past Accepting new patients

Locations

295 Varnum Ave
Lowell, MA 01854
Phone (978) 788-7344

600 Clark Rd
Ste 3
Tewksbury, MA 01876
Phone (978) 851-4141

600 Clark Rd
Tewksbury, MA 01876
Phone (978) 452-3453

Organizations & group practices 2

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 3

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": "1273190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490832000000",
    "number": "1922326529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 CLARK RD",
            "address_2": "SUITE 3",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018761699",
            "telephone_number": "978-851-4141",
            "fax_number": "978-788-7911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 CLARK RD",
            "address_2": "SUITE 3",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018761699",
            "telephone_number": "978-851-4141",
            "fax_number": "978-788-7911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLATO",
        "first_name": "EMELYN",
        "middle_name": "BORJA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-05-07",
        "last_updated": "2017-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MT196661",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "255142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tewksbury, MA

Sources for this page

Verify at the official NPI Registry.