| Iora Health Massachusetts, P.c. | |
|
287 Middlesex Ave Medford MA 02155-5056 | |
| (781) 222-3033 | |
| (781) 281-9927 |
| Full Name | Iora Health Massachusetts, P.c. |
|---|---|
| Speciality | Internal Medicine |
| Location | 287 Middlesex Ave, Medford, Massachusetts |
| Authorized Official Name and Position | Rushika Fernandopulle (PRESIDENT) |
| Authorized Official Contact | 6178045981 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Iora Health Massachusetts, P.c. 101 Tremont St Fl 6 Boston MA 02108-5004 Ph: (617) 804-5891 | Iora Health Massachusetts, P.c. 287 Middlesex Ave Medford MA 02155-5056 Ph: (781) 222-3033 |
| NPI Number | 1255842936 |
|---|---|
| Provider Enumeration Date | 10/20/2017 |
| Last Update Date | 10/20/2017 |
| Medicare PECOS PAC ID | 9638435035 |
|---|---|
| Medicare Enrollment ID | O20171116002743 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255842936 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Sharon A Mahoney |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205974722 PECOS PAC ID: 8628096872 Enrollment ID: I20051105000208 |
| Provider Name | Andrew S Flewwelling |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396717468 PECOS PAC ID: 2769476100 Enrollment ID: I20060216000050 |
| Provider Name | Jane W Craig |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1952461402 PECOS PAC ID: 0648364505 Enrollment ID: I20070922000042 |
| Provider Name | Kalpna Thuraisamy |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1245315290 PECOS PAC ID: 0648290361 Enrollment ID: I20100524000037 |
| Provider Name | Halary Patch |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255631248 PECOS PAC ID: 0840461018 Enrollment ID: I20110920000109 |
| Provider Name | Matthew S Favazza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699114512 PECOS PAC ID: 0547403040 Enrollment ID: I20130903000301 |
| Provider Name | Mary- Amanda W O'neill |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1548550882 PECOS PAC ID: 2466773247 Enrollment ID: I20151211000876 |
| Provider Name | Ronald Englert |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1053376533 PECOS PAC ID: 9335205277 Enrollment ID: I20161205001661 |
| Provider Name | Erik Funk |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043214398 PECOS PAC ID: 1052385606 Enrollment ID: I20170125002379 |
| Provider Name | David H Gellis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548580368 PECOS PAC ID: 2163795287 Enrollment ID: I20171219000825 |
| Provider Name | Leah Coburn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1962978957 PECOS PAC ID: 5991049397 Enrollment ID: I20181211002023 |
| Provider Name | Emilie Gruhl |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1447663927 PECOS PAC ID: 0042431256 Enrollment ID: I20220106000798 |
| Provider Name | Pei-chun Mcgregor |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1023231073 PECOS PAC ID: 5890919906 Enrollment ID: I20230307000597 |
| Provider Name | Jaclyn Hastings |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821523994 PECOS PAC ID: 1557613353 Enrollment ID: I20230821000393 |
| Provider Name | Sheila Miriam Antony |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1083989339 PECOS PAC ID: 7810281003 Enrollment ID: I20240805001985 |
| Provider Name | Angela Poppe Ries |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1346458197 PECOS PAC ID: 6608961081 Enrollment ID: I20241024000159 |
| Provider Name | Ambreen Mohamed |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1437443637 PECOS PAC ID: 4183944788 Enrollment ID: I20241203004332 |
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