| Hkd Outreach Pc | |
|
25 Melville Ave Dorchester MA 02124-2105 | |
| (617) 699-9329 | |
| (844) 564-1409 |
| Full Name | Hkd Outreach Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 25 Melville Ave, Dorchester, Massachusetts |
| Authorized Official Name and Position | Hung K Do (CEO) |
| Authorized Official Contact | 9787109877 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Hkd Outreach Pc 25 Melville Ave Dorchester MA 02124-2105 Ph: (617) 699-9329 | Hkd Outreach Pc 25 Melville Ave Dorchester MA 02124-2105 Ph: (617) 699-9329 |
| NPI Number | 1982082723 |
|---|---|
| Provider Enumeration Date | 05/13/2015 |
| Last Update Date | 05/18/2022 |
| Certification Date | 05/18/2022 |
| Medicare PECOS PAC ID | 0547570806 |
|---|---|
| Medicare Enrollment ID | O20151117001695 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982082723 | NPI | - | NPPES |
| Provider Name | Jose Azocar |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1578549499 PECOS PAC ID: 6608765482 Enrollment ID: I20041213000699 |
| Provider Name | Shorta Yuasa |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629024328 PECOS PAC ID: 3072565126 Enrollment ID: I20050216000790 |
| Provider Name | Yulan Wang |
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation |
| Provider Identifiers | NPI Number: 1992795538 PECOS PAC ID: 8224062724 Enrollment ID: I20050923000650 |
| Provider Name | Hung K Do |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013069962 PECOS PAC ID: 2860578846 Enrollment ID: I20080401000279 |
| Provider Name | Alex I Varghese |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1679788657 PECOS PAC ID: 4385712991 Enrollment ID: I20081009000532 |
| Provider Name | Mari Stackpoole |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790013910 PECOS PAC ID: 8224167267 Enrollment ID: I20100601000012 |
| Provider Name | Claire Jacobus |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1932272176 PECOS PAC ID: 9739470824 Enrollment ID: I20160621000764 |
| Provider Name | Robert Sampson |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1699844597 PECOS PAC ID: 3476844598 Enrollment ID: I20160621001871 |
| Provider Name | Adam Bied |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1104185586 PECOS PAC ID: 4082992607 Enrollment ID: I20161101001834 |
| Provider Name | Tena Chau |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528669264 PECOS PAC ID: 9234544578 Enrollment ID: I20210218000230 |
| Provider Name | Chloe Hill |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356941140 PECOS PAC ID: 6608275136 Enrollment ID: I20210602003311 |
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