| Root Family Medicine Pc | |
|
3 Edgewater Dr Ste 102 Norwood MA 02062-4644 | |
| (774) 221-7697 | |
| (781) 352-2274 |
| Full Name | Root Family Medicine Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 3 Edgewater Dr Ste 102, Norwood, Massachusetts |
| Authorized Official Name and Position | Sarah Byrne (OWNER/MEDICAL DIRECTOR) |
| Authorized Official Contact | 5089287668 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Root Family Medicine Pc 3 Edgewater Dr Ste 102 Norwood MA 02062-4644 Ph: (508) 928-7668 | Root Family Medicine Pc 3 Edgewater Dr Ste 102 Norwood MA 02062-4644 Ph: (774) 221-7697 |
| NPI Number | 1346625985 |
|---|---|
| Provider Enumeration Date | 07/24/2015 |
| Last Update Date | 09/28/2023 |
| Medicare PECOS PAC ID | 2668782137 |
|---|---|
| Medicare Enrollment ID | O20151112002231 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346625985 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Maryjo M Mackinnon |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932225794 PECOS PAC ID: 3577660877 Enrollment ID: I20070522000183 |
| Provider Name | Sarah J Byrne |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720241490 PECOS PAC ID: 9335316348 Enrollment ID: I20120114000003 |
| Provider Name | Ziesl J Maayan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1669890521 PECOS PAC ID: 6507086659 Enrollment ID: I20141013001744 |
| Provider Name | Caitlin K Stauder |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1346628690 PECOS PAC ID: 1759611932 Enrollment ID: I20191001003482 |
| Provider Name | Jesse Mccabe |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1932724093 PECOS PAC ID: 8921410606 Enrollment ID: I20201222002213 |
| Provider Name | Kelsey Walsh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235747502 PECOS PAC ID: 1052760196 Enrollment ID: I20231214000494 |
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