NPIMap

Individual provider Active NPI

Pamela J Sansoucy, M.D.

  • Family Medicine Physician
  • Holden, MA
National Provider Identifier
1982022935
Registry record updated Jun 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
260584 Issued in MA
Practice address
64 Boyden Rd
Holden, MA 01520-2570
Phone
(508) 829-6765
Fax
(508) 829-1884
NPI assigned
Apr 6, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 260584 MA Primary

Addresses

Primary practice location

64 Boyden Rd
Holden, MA 01520-2570

Mailing address

64 Boyden Rd
Holden, MA 01520-2570
Phone (508) 829-6765

Other names 1

  • Pamela Glennon Other name

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
I20170713001601 MA Practitioner - Family PracticePractitioner - Internal Medicine 1951527290 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

64 Boyden Rd
Holden, MA 01520-2570
Phone (508) 829-6765

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
260584MAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Heywood Medical Group Inc. Family Medicine CurrentSince Jul 1, 2017 Accepting new patients
Heywood Affiliated Medical Group Inc. CurrentSince Jul 1, 2017 Accepting new patients
Henry Heywood Memorial Hospital Family Medicine CurrentSince Mar 23, 2020 Accepting new patients
Reliant Medical Group, Inc Family Medicine CurrentSince May 8, 2023 Accepting new patients
Henry Heywood Memorial Hospital CurrentSince Mar 23, 2020 Accepting new patients
Athol Memorial Hospital Incorporated Family Medicine CurrentSince May 1, 2018 Accepting new patients

Locations

2033 Main St
Athol, MA 01331
Phone (978) 249-1295

242 Green St
Gardner, MA 01440
Phone (978) 258-4734

250 Green St
Gardner, MA 01440
Phone (978) 630-5050

266 Main St
Gardner, MA 01440
Phone (978) 630-5030

64 Boyden Rd
Holden, MA 01520
Phone (508) 829-6765

16 Wyman Rd
Westminster, MA 01473
Phone (978) 874-6409

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

5 Neponset St
Fl 12
Worcester, MA 01606
Phone (508) 852-6175

Interoperability endpoints

  • Direct secure messaging: pamela.sansoucy.1@192.direct.athenahealth.com
  • Direct secure messaging: pamela.sansoucy.npi1982022935.reliant@direct.optumcare.masshiway.net

Organizations & group practices 6

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 6

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": "1396742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685923200000",
    "number": "1982022935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 BOYDEN RD",
            "city": "HOLDEN",
            "state": "MA",
            "postal_code": "015202570",
            "telephone_number": "508-829-6765",
            "fax_number": "508-829-1884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 BOYDEN RD",
            "city": "HOLDEN",
            "state": "MA",
            "postal_code": "015202570",
            "telephone_number": "508-829-6765",
            "fax_number": "508-829-1884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANSOUCY",
        "first_name": "PAMELA",
        "middle_name": "J",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-06",
        "last_updated": "2023-06-05",
        "certification_date": "2023-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "260584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAMELA",
            "last_name": "GLENNON",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Holden, MA

Sources for this page

Verify at the official NPI Registry.