SHORTA YUASA (NPI# 1629024328) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1629024328 |
Entity Type | Individual |
Full Name | SHORTA YUASA |
Credential | M.D. |
Practice Address |
295 Varnum Ave Lowell MA 01854-2134 |
Mailing Address |
295 Varnum Ave Lowell MA 01853-1802 |
Practice Telephone | 9789376161 |
Mailing Telephone | 9789376161 |
Enumeration Date | 2006-05-25 |
Last Update Date | 2015-12-15 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 207P00000X | Emergency Medicine | 153944 | MA | Allopathic & Osteopathic Physicians |
Y | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
153944 | MA | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MA | 3171353 | 05 | |
MA | BCBS | J17924 | 01 |
Street Address |
295 VARNUM AVE |
City | LOWELL |
State | MA |
Zip Code | 01854-2134 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1215931597 | Jonas J Berman | Radiology | 295 Varnum Ave, Lowell, MA 01854-2134 | 2005-06-02 |
1437758125 | Amy Marie Dellogono | Nurse Practitioner | 295 Varnum Ave, Lowell, MA 01854-2134 | 2020-10-22 |
1720686108 | Emily Rose Claude | Family Medicine | 295 Varnum Ave, Lowell, MA 01854-2134 | 2020-10-16 |
1265041305 | The Lowell General Hospital | Emergency Medical Technician, Paramedic | 295 Varnum Ave, Lowell, MA 01854-2134 | 2020-07-24 |
1639714744 | Shara A King | Nurse Practitioner | 295 Varnum Ave, Lowell, MA 01854-2134 | 2019-11-12 |
1861036451 | Obhg Massachusetts - Lowell PC | Emergency Medicine | 295 Varnum Ave, Lowell, MA 01854-2134 | 2019-11-06 |
1871147264 | Ronald Wilson Makarutsa | Registered Nurse | 295 Varnum Ave, Lowell, MA 01854-2134 | 2019-07-24 |
1780236786 | Andrea Jennifer Desmond | Nurse Practitioner | 295 Varnum Ave, Lowell, MA 01854-2134 | 2019-07-10 |
1235791831 | Nicole Nolan | Pharmacist | 295 Varnum Ave, Lowell, MA 01854-2193 | 2019-07-03 |
1578123253 | Alec Garabedian | Nurse Anesthetist, Certified Registered | 295 Varnum Ave, Lowell, MA 01854-2134 | 2019-06-16 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780224246 | Alexander C Mellin | Specialist/Technologist | Costello Athletic Center, 275 Riverside Street, Lowell, MA 01854 | 2020-01-13 |
1831656131 | Shaquilla U Terry | Behavior Technician | 810 Broadway St, Apt 5, Lowell, MA 01854 | 2019-02-23 |
1073010187 | John R Dunn | Counselor | Lowell House Inc, 555 Merrimack Street, Lowell, MA 01854 | 2018-04-06 |
1730604661 | Grecia Aybar | Counselor | 11 White Street, Lowell, MA 01854 | 2017-08-11 |
1659812550 | Krystal Demmons | Counselor | 371 Varnum Ave, Lowell, MA 01854 | 2017-03-13 |
1891115366 | Stacey Bourbeau | Counselor | 391 Varnum Avenue Lower Level, Lowell, MA 01854 | 2014-04-23 |
1013270446 | Alexandra Miniati | Internal Medicine | 275 Varnum Ave Riverside Medical Group, Ste 201, Lowell, MA 01854 | 2012-06-20 |
1750608923 | Elisha S Bartlett | Social Worker | 391 Varnum Avenue, Lowell, MA 01854 | 2010-04-28 |
1871820399 | Sandy Ann Thongkhamsouk | Counselor | 391 Varnum St., Lowell, MA 01854 | 2009-11-04 |
1427299007 | Kristin A. Larson | Nurse Practitioner | 220 Pawtucket St Suite 300, University Crossing, Lowell, MA 01854 | 2009-03-12 |
Find all providers in zip 01854 |
Taxonomy Code | 207RA0401X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Internal Medicine |
Specialization | Addiction Medicine |
An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. |
Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1154804698 | Bay Medical Systems Associates LLC | Internal Medicine | 29 Main St Ste 101, Millbury, MA 01527-2005 | 2018-09-11 |
1619491198 | Willett & Associates | Internal Medicine | 22 Adams St Ste 1, Lynn, MA 01902-2804 | 2017-07-27 |
1275897092 | Jeoffrey Michael Hill | Internal Medicine | 100 Stone Manor Dr, New Marlborough, MA 01230-9744 | 2012-06-26 |
1487944914 | William Robert Caruso | Internal Medicine | 8 Winthrop Ave, Po 1153, Duxbury, MA 02332-5207 | 2011-04-18 |
1417139700 | David Anthony Tortorella | Internal Medicine | 170 Main St Units G4-g8, Tewksbury, MA 01876 | 2007-11-29 |
1609920776 | Theodore Treibick | Internal Medicine | 138 East St, Carlisle, MA 01741-1105 | 2007-01-23 |
1174544548 | William M Burke | Internal Medicine | 157 Temple St, West Roxbury, MA 02132-3804 | 2006-07-21 |
1083633580 | Michael J.f. Iannessa | Internal Medicine | 1233 State Rd, Plymouth, MA 02360-5133 | 2006-07-18 |
1235165291 | Robert Barry Downes | Internal Medicine | 169 Pine St, Natick, MA 01760-1332 | 2006-06-23 |
1669430526 | Alan A Wartenberg | Internal Medicine | 3 Prince St, Attleboro, MA 02703-1613 | 2006-05-02 |
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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.