ANDREW W ZIMMERMAN (NPI# 1184682577) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184682577 |
| Entity Type | Individual |
| Full Name | ANDREW W ZIMMERMAN |
| Credential | M.D. |
| Practice Address |
55 Lake Ave N Pediatric Neurology Worcester MA 01655-0002 |
| Mailing Address |
Po Box 415348 Boston MA 02241-5348 |
| Practice Telephone | 7744425695 |
| Practice Fax Number | 5088564287 |
| Mailing Telephone | 8002258885 |
| Mailing Fax Number | 5083341977 |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2017-05-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 208000000X | Pediatrics | 216753 | MA | Allopathic & Osteopathic Physicians |
| Y | 2080P0008X |
Pediatrics Specialization: Neurodevelopmental Disabilities |
216753 | MA | Allopathic & Osteopathic Physicians |
| N | 2084N0402X |
Psychiatry & Neurology Specialization: Neurology with Special Qualifications in Child Neurology |
216753 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | MEDICARE | S400104406 | 01 |
| MA | 110033314A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598135949 | Andrew Zimmerman | Pharmacist | 401 Bicentennial Way # 1, Suite 155, Santa Rosa, CA 95403-2149 | 2015-09-28 |
| 1790124063 | Andrew Wayne Zimmerman | Social Worker | 815 E 14th St, Apt. 6l, Brooklyn, NY 11230-2957 | 2013-06-20 |
| 1609911502 | Andrew Williams Zimmerman | Dentist | 402 East Market St, Clearfield, PA 16830 | 2007-02-20 |
| 1255725669 | Andrew Russell Zimmerman | Physician Assistant | 120 William Penn Plz, Durham, NC 27704-2150 | 2015-03-24 |
| 1871915033 | Andrew Zimmerman | Physical Therapist | 3242 20th St S, Fargo, ND 58104-5917 | 2014-01-07 |
| 1871883462 | Andrew Zimmerman | Student in an Organized Health Care Education/Training Program | 550 1st Ave, New York, NY 10016-6402 | 2011-04-15 |
| 1932134251 | Andrew A. Zimmerman | Anesthesiology | 3626 Ruffin Rd, San Diego, CA 92123-1810 | 2006-07-12 |
| Street Address |
55 LAKE AVE N PEDIATRIC NEUROLOGY |
| City | WORCESTER |
| State | MA |
| Zip Code | 01655-0002 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477556587 | James E Liebmann | Internal Medicine | 55 Lake Ave N, Hematology/oncology, Worcester, MA 01655-0002 | 2005-05-23 |
| 1518568732 | Justin Bullard | Psychologist | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-11-04 |
| 1346849825 | Meghan Moore | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-10-26 |
| 1174122899 | Jessica Goncalves Ferreira | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-10-23 |
| 1235746686 | Desiree Mytych | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-09-29 |
| 1659986248 | Rebecca Lynn Harris | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-09-10 |
| 1639781487 | Gabriella Kathleen Holland | Student in an Organized Health Care Education/Training Program | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-21 |
| 1730791898 | Kerry Anne Benedict | Speech-Language Pathologist | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-20 |
| 1902418999 | Natasha R. Turner | Genetic Counselor, MS | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-20 |
| 1144830712 | Abbey Corsini | Nurse Practitioner | 55 Lake Ave N, Worcester, MA 01655-0002 | 2020-08-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205489713 | Darryl Sweeper Jr. | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Psychiatry, Umass Memorial Medical Center, Worcester, MA 01655 | 2019-07-23 |
| 1225690530 | Ryan Zenevitch | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Family Medicine, Umass Memorial Medical Center, Worcester, MA 01655 | 2019-07-08 |
| 1932688454 | Victoria Sayeg | Student in an Organized Health Care Education/Training Program | 55 Lake Avenue North, Pediatrics, Worcester, MA 01655 | 2018-08-07 |
| 1114425675 | Judith Dio Wentzell | Social Worker | Umassmemorial Medical Center, 55 Lake Ave North, Dept of Care Coordination, Worcester, MA 01655 | 2018-01-30 |
| 1861927386 | Muhammad Waqas Khan | Student in an Organized Health Care Education/Training Program | University of Massachusetts 55 North Lake Ave, Neurology, Worcester, MA 01655 | 2017-04-21 |
| 1861806192 | Qaiser Shamshir Khan | Psychiatry & Neurology | 55 Lake Ave N # S7-831, Worcester, MA 01655 | 2014-06-14 |
| 1073858981 | Heidi Glover | Nurse Practitioner | 55 Lake Ave North Dept. of Pedi-adolescent, Ummc University Campus, Worcester, MA 01655 | 2012-12-04 |
| 1972867992 | Anna Bjornsdottir | Psychiatry & Neurology | 55 Lake Av N, Worcester, MA 01655 | 2012-06-25 |
| 1245567676 | Steven Edward Mckinley | Nurse Practitioner | 55 Lake Ave. North, Umass Memorial Medical Center University Campus, Worcester, MA 01655 | 2009-11-05 |
| 1851582951 | Robin I Davidson | Neurological Surgery | 55 Lake Ave, North, Ummhc-univ Campus, Worcester, MA 01655 | 2007-08-05 |
| Find all providers in zip 01655 | ||||
| Taxonomy Code | 2080P0008X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Neurodevelopmental Disabilities |
| A pediatrician who treats children having developmental delays or learning disorders including those associated with visual and hearing impairment, mental retardation, cerebral palsy, spina bifida, autism and other chronic neurologic conditions. This specialist provides medical consultation and education and assumes leadership in the interdisciplinary management of children with neurodevelopmental disorders. They may also focus on the early identification and diagnosis of neurodevelopmental disabilities in infants and young children as well as on changes that occur as the child with developmental disabilities grows. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source changed] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275042012 | Amanda Lee Bartlett | Pediatrics | 1 Rounder Way, Burlington, MA 01803-5157 | 2017-09-25 |
| 1619498425 | Chariton Moschopoulos | Pediatrics | 300 Longwood Ave, Boston, MA 02115 | 2017-06-30 |
| 1659757326 | Alessandra Biffi | Pediatrics | 300 Longwood Ave, Karp 8, Boston, MA 02115-5724 | 2015-08-05 |
| 1477999522 | Nicolas Julian Abreu | Pediatrics | 300 Longwood Ave # Fegan11, Boston, MA 02115 | 2013-05-16 |
| 1871824342 | Lauren Doyle Strauss | Pediatrics | 75 Francis St, Boston, MA 02115-6110 | 2010-01-24 |
| 1295994846 | Karen Alexis Spencer | Pediatrics | 300 Longwood Ave, Fegan 11, Boston, MA 02115-5724 | 2008-06-07 |
| 1427243237 | Nicole Tara Baumer | Pediatrics | 55 Fruit Street, Massachusetts General Hospital, Boston, MA 02114 | 2007-09-14 |
| 1003984972 | Ludwik S Szymanski | Pediatrics | 300 Longwood Ave, Boston, MA 02115-5724 | 2006-12-01 |
| 1629082342 | Neuropediatrix PC Inc | Pediatrics | 1563 Fall River Ave, Unit 1, Seekonk, MA 02771-3736 | 2006-07-28 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.