PRADEEP P NAZAREY (NPI# 1386798700) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386798700 |
| Entity Type | Individual |
| Full Name | PRADEEP P NAZAREY |
| Credential | M.D. |
| Practice Address |
55 Lake Ave N Department of Surgery Worcester MA 01655-0002 |
| Mailing Address |
Po Box 415348 Boston MA 02241-5348 |
| Practice Telephone | 5088562128 |
| Practice Fax Number | 5088562043 |
| Mailing Telephone | 8002252225 |
| Mailing Fax Number | 5083341977 |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2017-04-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0120X |
Surgery Specialization: Pediatric Surgery |
237921 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 110080618A | 05 |
| Street Address |
55 LAKE AVE N DEPARTMENT OF SURGERY |
| 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 | 2086S0120X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Pediatric Surgery |
| A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518127075 | Muriel Aya Cleary | Surgery | 55 Lake Ave N, Worcester, MA 01655-0002 | 2008-06-09 |
| 1750558508 | Jeremy T Aidlen | Surgery | 55 Lake Ave N, Division of Pediatric Surgery, Worcester, MA 01655-0002 | 2008-05-12 |
| 1861475980 | Michael P Hirsh | Surgery | 55 Lake Ave N, Department of Pediatric Surgery, Worcester, MA 01655-0002 | 2005-11-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629360680 | Cornelia Little Griggs | Surgery | 55 Fruit St Dept Of, Boston, MA 02114-2621 | 2011-05-10 |
| 1720270606 | Belinda Hsi Dickie | Surgery | 300 Longwood Ave # Fegan3, Boston, MA 02115-5724 | 2007-08-14 |
| 1346395076 | Patrick J Javid | Surgery | Children's Hospital Fegan 3, 300 Longwood Ave, Boston, MA 02115 | 2007-01-24 |
| 1285671875 | Mark Puder | Surgery | 300 Longwood Ave/fegan 3, Children's Hospital, Boston, MA 02115 | 2006-06-01 |
| 1326098419 | Brian F. Gilchrist | Surgery | 750 Washington Street, The Floating Hospital for Children, Boston, MA 02111 | 2006-05-11 |
| 1689634933 | Ronald Rubin | Surgery | 40 Wykeham Road, West Newton, MA 02465-2420 | 2006-03-23 |
| 1184936320 | Prathima Nandivada | Surgery | 300 Longwood Ave, Boston, MA 02115-5724 | 2010-07-03 |
| 1821317587 | Farokh Rustom Demehri | Surgery | 300 Longwood Ave, Boston, MA 02115-5724 | 2010-05-20 |
| 1326206152 | Artur Chernoguz | Surgery | 800 Washington St, Boston, MA 02111-1552 | 2008-05-29 |
| 1174794556 | Jill M Zalieckas | Surgery | 300 Longwood Ave, Fegan 3, Boston, MA 02115-5724 | 2008-03-13 |
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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.