CleanSlate Centers – Addiction Medicine (Internal Medicine) Physician, NPI 1770816506
Addiction Medicine (Internal Medicine) Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for CleanSlate Centers
244 MAIN STREET ANNEX
NORTHAMPTON, MA 010610032
Phone: (413) 584-2173
Type: Location
Century Boulevard, Nashville, Davidson County, Tennessee, 37214, United States
NASHVILLE, TN 372143692
Phone: (615) 425-0220
Type: Mailing
8 CADILLAC DR STE 300
BRENTWOOD, TN 370275337
Phone: (615) 425-0220
Fax: (833) 279-7074
Type: Mailing
900 MEMORIAL AVE
WEST SPRINGFIELD, MA 010893557
Phone: (413) 788-0100
Fax: (833) 279-7074
Type: Location
12 CADILLAC DR STE 380
BRENTWOOD, TN 370275362
Phone: (615) 601-5576
Type: Mailing
8 CADILLAC DR STE 180
BRENTWOOD, TN 370275393
Phone: (615) 425-0220
Fax: (833) 279-7074
Type: Mailing
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: 2010-06-28
PECOS data refreshed: 2026-06-15
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20100628000153 | O | Clinic/Group Practice | MA | TBD |
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.
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 01061)
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