| Pai Participant Ma Pc | |
|
111 Orient Ave East Boston MA 02128-1006 | |
| (617) 596-2100 | |
| Not Available |
| Full Name | Pai Participant Ma Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 111 Orient Ave, East Boston, Massachusetts |
| Authorized Official Name and Position | Jill Ford (SR. MANAGER OF CREDENTIALINGF) |
| Authorized Official Contact | 4846676032 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Pai Participant Ma Pc Po Box Po Box 639676 Cincinnati OH 45263-9676 Ph: (859) 291-4800 | Pai Participant Ma Pc 111 Orient Ave East Boston MA 02128-1006 Ph: (617) 596-2100 |
| NPI Number | 1932984317 |
|---|---|
| Provider Enumeration Date | 08/25/2023 |
| Last Update Date | 08/25/2023 |
| Medicare PECOS PAC ID | 9537513684 |
|---|---|
| Medicare Enrollment ID | O20230925000533 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932984317 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Michael Walger |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1225142110 PECOS PAC ID: 5294794285 Enrollment ID: I20041006000118 |
| Provider Name | Mark J Samuelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1679502405 PECOS PAC ID: 6901866607 Enrollment ID: I20041018000261 |
| Provider Name | Mark S Ostrem |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1811985633 PECOS PAC ID: 6305803958 Enrollment ID: I20041215000212 |
| Provider Name | Deborah A O'keefe |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1538159579 PECOS PAC ID: 0244297802 Enrollment ID: I20041215000284 |
| Provider Name | Dragana Doran |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1750451795 PECOS PAC ID: 7517909450 Enrollment ID: I20050601000565 |
| Provider Name | John M Stevenson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043284789 PECOS PAC ID: 5991787210 Enrollment ID: I20060126000558 |
| Provider Name | Shaohua Deng |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174760326 PECOS PAC ID: 5294899738 Enrollment ID: I20090129000067 |
| Provider Name | David Chiang |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1124219506 PECOS PAC ID: 2769533793 Enrollment ID: I20090702000024 |
| Provider Name | Richard M Pfeiffer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235432501 PECOS PAC ID: 6709067705 Enrollment ID: I20110224000124 |
| Provider Name | Vishal Kuchaculla |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1386837342 PECOS PAC ID: 5799832853 Enrollment ID: I20110325000565 |
| Provider Name | Akindele Majekodunmi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447411764 PECOS PAC ID: 9436325560 Enrollment ID: I20111220000571 |
| Provider Name | Stephanie I Cody |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205098522 PECOS PAC ID: 6204986151 Enrollment ID: I20130311000311 |
| Provider Name | Marie-helene Almonor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972661064 PECOS PAC ID: 6103832365 Enrollment ID: I20140523000566 |
| Provider Name | Judith Bellevue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972908143 PECOS PAC ID: 5092030858 Enrollment ID: I20150219000887 |
| Provider Name | Alicyn M Walsh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1245689652 PECOS PAC ID: 0345534715 Enrollment ID: I20160808001292 |
| Provider Name | Fariyda Mulrain |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831644129 PECOS PAC ID: 2466730114 Enrollment ID: I20161031001748 |
| Provider Name | Melissa R Willette |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922550557 PECOS PAC ID: 6406137207 Enrollment ID: I20170110003377 |
| Provider Name | Susan C Powers |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174800957 PECOS PAC ID: 7911210836 Enrollment ID: I20170828003960 |
| Provider Name | Stella Uchendu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891232906 PECOS PAC ID: 9436416492 Enrollment ID: I20171129000733 |
| Provider Name | Nathaniel Minh Dang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477109627 PECOS PAC ID: 1658705215 Enrollment ID: I20200107002638 |
| Provider Name | George M Kokolski |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1275590879 PECOS PAC ID: 8820178064 Enrollment ID: I20201125001064 |
| Provider Name | Elmira Basaly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1841511441 PECOS PAC ID: 3870734320 Enrollment ID: I20201204002334 |
| Provider Name | Robert Tavares |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1871199638 PECOS PAC ID: 4284047382 Enrollment ID: I20210111000837 |
| Provider Name | Paola Sheila Buchanan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1104423482 PECOS PAC ID: 1850700865 Enrollment ID: I20210504001033 |
| Provider Name | Yini Jiang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497348908 PECOS PAC ID: 4587061320 Enrollment ID: I20210922000552 |
| Provider Name | Alexandra K Weinstein |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1679249957 PECOS PAC ID: 1759788276 Enrollment ID: I20210927002284 |
| Provider Name | Sarah Mcdevitt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538833751 PECOS PAC ID: 1153719059 Enrollment ID: I20211026002463 |
| Provider Name | Yingqi Zhang |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013673151 PECOS PAC ID: 5092105197 Enrollment ID: I20211203001876 |
| Provider Name | Bridget Ross-fitzgibbons |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144688102 PECOS PAC ID: 2961782826 Enrollment ID: I20221130000146 |
| Provider Name | Christine Miranda |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184295917 PECOS PAC ID: 1951773514 Enrollment ID: I20230207002799 |
| Provider Name | Chong-ae Donahue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043794704 PECOS PAC ID: 4587917240 Enrollment ID: I20230411000145 |
| Provider Name | Farrah Fleurima |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588356067 PECOS PAC ID: 7618322728 Enrollment ID: I20231010001994 |
| Provider Name | Irena Urszula Lisek |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1053905166 PECOS PAC ID: 1951751254 Enrollment ID: I20231228003455 |
| Provider Name | Meliha Avdic-bajramovic |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1366116907 PECOS PAC ID: 5890230809 Enrollment ID: I20240715002614 |
Medical Associates Of Ebnhc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10 Gove St, East Boston, MA 02128 Phone: 617-569-5800 Fax: 617-568-4780 | |
Neighborhealth Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 10 Gove St, East Boston, MA 02128 Phone: 617-569-5800 Fax: 617-568-4756 | |
Excel Physical Therapy, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2 Neptune Rd Suite 171, East Boston, MA 02128 Phone: 617-895-7684 | |
Internal Medical Associates-ebnhc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 10 Gove St, East Boston, MA 02128 Phone: 617-569-5800 Fax: 617-568-4756 | |
North Suffolk Community Services Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 14 Porter St, East Boston, MA 02128 Phone: 617-569-3189 Fax: 617-569-7890 | |
Central Square Medical Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 40 Central Sq, East Boston, MA 02128 Phone: 617-202-9036 | |
American Current Care Of Massachusetts Pc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1 Harborside Dr, East Boston, MA 02128 Phone: 617-265-6500 Fax: 617-568-6573 |