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MEDIGROUP PC NPI 1669588372


NPI Information

NPI: 1669588372
Provider Name: MEDIGROUP PC
Classification: Neuromusculoskeletal Medicine, Sports Medicine - 204C00000X
Entity Type: Organization
Address:
4 FRANK LEARY WAY
RANDOLPH, MA
ZIP 02368
Phone: (781) 986-1737
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MEDIGROUP PC is a neuromusculoskeletal medicine sports medicine in Randolph, MA. The provider is a Neuromusculoskeletal Medicine and Osteopathic Manipulative Medicine physician trained to be responsible for the continuous care in the field of sports medicine encompasses increased knowledge and understanding of osteopathic principles and practice and heightened technical skills of osteopathic manipulative medicine and integrates each of these into the management of the individual engaged in physical exercise (sports) whether as an individual or in team participation. Source: American Osteopathic Association Additional Resources: AOA Osteopathic Board Certification in Neuromusculoskeletal Medicine; https://certification.osteopathic.org/sports-medicine/ MEDIGROUP PC NPI is 1669588372. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4 FRANK LEARY WAY
RANDOLPH, MA
ZIP 02368-512
Phone: (781) 986-1737
Fax: (781) 986-0507

The provider's authorized official is Mark Weiner .
The authorized official title is Owner and has the following contact phone number (781) 986-1737.

The enumeration date for this NPI number is 8/23/2006 and was last updated on 9/10/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1204C00000XNeuromusculoskeletal Medicine, Sports Medicine54262MASSACHUSETTSYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1B99137MEDICARE UPINMASSACHUSETTS
2M21417MEDICARE ID-TYPE UNSPECIFIEDMASSACHUSETTS
39725288MEDICAIDMASSACHUSETTS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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