Revere Medical of Massachusetts, PC
NPI 1336976539ActiveOrganization· Internal Medicine· Brockton, MA
Internal Medicine in Brockton, Massachusetts, registered in NPPES in September 2024. The authorized official on file is Jane Holden, Billing Manager. Enrolled in Medicare as part b supplier - clinic/group practice and part b supplier - clinic/group practice.
Overview
| NPI | 1336976539 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 19, 2024 |
| Last updated in NPPES | Jun 14, 2025 |
| Certified by provider | May 14, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine Primary | 207R00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (MA); Part B Supplier - Clinic/Group Practice (NH) |
|---|
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