MIRIAM S. BUCKBERG (NPI# 1578549010) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578549010 |
| Entity Type | Individual |
| Full Name | MIRIAM S. BUCKBERG |
| Other Name | MELINDA S. SHADOWITZ |
| Credential | MD |
| Practice Address |
701 Enfield Street Enfield CT 06082 |
| Mailing Address |
2150 Main Street Springfield MA 01104 |
| Practice Telephone | 8607416058 |
| Practice Fax Number | 8602539326 |
| Mailing Telephone | 4137395676 |
| Mailing Fax Number | 4137335860 |
| Enumeration Date | 2005-12-16 |
| Last Update Date | 2020-01-31 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 251720 | MA | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 017423 | ME | Allopathic & Osteopathic Physicians |
| N | 207Q00000X | Family Medicine | 35070556 | OH | Allopathic & Osteopathic Physicians |
| N | 207R00000X | Internal Medicine | 64731 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OH | RAILROAD MEDICARE NUMBER | 080189297 | 01 |
| ME | ANTHEM ME | 099883 | 01 |
| ME | 432710699 | 05 | |
| OH | 2046637 | 05 | |
| ME | HPHC | AA99889 | 01 |
| Street Address |
701 ENFIELD STREET |
| City | ENFIELD |
| State | CT |
| Zip Code | 06082 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376153635 | Jamie Helen Scott | Registered Nurse | 701 Enfield Street, Enfield, CT 06082 | 2020-08-03 |
| 1639596752 | Claudia Artime | Internal Medicine | 701 Enfield Street, Enfield, CT 06082 | 2014-03-26 |
| 1215245543 | Kaitlin G. Pulito | Physician Assistant | 701 Enfield Street, Enfield, CT 06082 | 2010-09-21 |
| 1629043625 | Peter John Drennan | Internal Medicine | 701 Enfield Street, Enfield, CT 06082 | 2006-02-22 |
| 1417935818 | Lisa Ann Howard | Family Medicine | 701 Enfield Street, Enfield, CT 06082 | 2006-01-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235611674 | Danielle Rock | Student in an Organized Health Care Education/Training Program | 153 Hazard Avenue, Enfield, CT 06082 | 2018-09-01 |
| 1871083980 | Alexa Swan | Registered Nurse | 160 Hazard Avenue, Enfield, CT 06082 | 2018-05-14 |
| 1194236869 | Cheryl Anne Gorton | Nurse Practitioner | 701 Enfield Street Enfield Medical Associates, Enfield, CT 06082 | 2017-10-20 |
| 1639695935 | Mw Wellness Viii, LLC | Family Medicine | 155 Hazard Ave Ste 2, Enfield, CT 06082 | 2017-08-17 |
| 1447770748 | Nanas 247 Home Care & Companion Agency LLC | Home Health | 7g The Hamlet, Enfield, CT 06082 | 2017-06-27 |
| 1366962920 | Caroline Laplante | Speech-Language Pathologist | 12 Trevor Dr, Enfield, CT 06082 | 2017-06-26 |
| 1740722487 | Gentle Dental Assoicates PC | Clinic/Center | 118 Elm Street, Enfield, CT 06082 | 2016-11-11 |
| 1386048007 | Michelle Mary Keane-taylor | Occupational Therapy Assistant | 1157 Enfield Street, Kindred Healthcare @ Parkway Pavilion, Enfield, CT 06082 | 2014-10-09 |
| 1780927517 | Kymberly A Lessard | Counselor | 37 King Court, Enfield, CT 06082 | 2013-03-29 |
| 1790068500 | Enfield Pediatric Dentistry LLC | Dentist | 233 Hazard Avenue, Enfield, CT 06082 | 2011-09-28 |
| Find all providers in zip 06082 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639695935 | Mw Wellness Viii, LLC | Family Medicine | 155 Hazard Ave Ste 2, Enfield, CT 06082 | 2017-08-17 |
| 1124344999 | David Beaufait | Family Medicine | 411 Us Route 4, Enfield, NH 03748-3168 | 2010-04-19 |
| 1396861985 | David W Beaufait | Family Medicine | 411 U.S. Route 4, Enfield, NH 03748 | 2007-03-22 |
| 1063429769 | William Bruce Spector | Family Medicine | 100 Hazard Ave, Suite 100, Enfield, CT 06082-5446 | 2006-08-02 |
| 1346700093 | Community Health Resources, Inc. | Family Medicine | 153 Hazard Ave, Enfield, CT 06082-4592 | 2019-03-20 |
| 1467979765 | New England Primary Care LLC | Family Medicine | 55 Hazard Ave, Enfield, CT 06082-3813 | 2017-08-28 |
| 1164608154 | Lynne E. Manning | Family Medicine | 5 N Main St, Enfield, CT 06082-3372 | 2008-01-21 |
| 1679761027 | Community Health Center Inc | Family Medicine | 5 N Main St, Enfield, CT 06082-3339 | 2007-10-11 |
| 1396766440 | Timothy Alan Fignar | Family Medicine | 15 Palomba Dr, Suite 5, Enfield, CT 06082-3888 | 2006-07-22 |
| 1548295827 | Nancy H Lindberg | Family Medicine | 113 Elm St, Suite 302, Enfield, CT 06082-3700 | 2006-07-12 |
| Find all providers in ENFIELD | ||||
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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.