PEMBROKE MEDICAL ASSOCIATES INC – Internal Medicine Physician, NPI 1194332759

PEMBROKE MEDICAL ASSOCIATES INC is a healthcare provider. based in Pembroke, Massachusetts. specializing in Internal Medicine Physician. The NPI Number for PEMBROKE MEDICAL ASSOCIATES INC is 1194332759

Main info

Organization
Name
PEMBROKE MEDICAL ASSOCIATES INC
NPI
1194332759
Phone
(781) 202-9292
Address
15 OLD WEST ELM ST
Authorized Official
DR. JOHN MICHAEL STEVENSON PRESIDENT MD
Enumeration Date
28 September 2020
Last Update Date
23 February 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience25
Completeness75
Years active:5State licenses:0Digital endpointsOther names

Provider Addresses for PEMBROKE MEDICAL ASSOCIATES INC

  • 15 OLD WEST ELM ST

    PEMBROKE, MA 023591731

    Phone: (781) 202-9292

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2020-10-06

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20201006002422OClinic/Group PracticeMATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 02359)

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Reviews

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Frequently asked questions

Can I cross-check PEMBROKE MEDICAL ASSOCIATES INC using NPI 1194332759?
NPI 1194332759 belongs to PEMBROKE MEDICAL ASSOCIATES INC; compare other details if you need extra assurance.
Is there an active status for PEMBROKE MEDICAL ASSOCIATES INC?
For scheduling context, PEMBROKE MEDICAL ASSOCIATES INC is shown as active in the registry.
What expertise is attributed to PEMBROKE MEDICAL ASSOCIATES INC?
PEMBROKE MEDICAL ASSOCIATES INC's specialty line reads Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Where in Massachusetts is PEMBROKE MEDICAL ASSOCIATES INC registered?
Use Pembroke, Massachusetts as the headline location for PEMBROKE MEDICAL ASSOCIATES INC here.
Does inactive status remove historical data?
Historical rows can remain visible after status changes — read the dates carefully.

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