Basic Information
| Provider Information | |||||||||
| NPI: | 1437127719 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | POPKIN | ||||||||
| FirstName: | JOEL | ||||||||
| MiddleName: | H | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 630 PLANTATION ST | ||||||||
| Address2: | |||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5085952513 | ||||||||
| FaxNumber: | 5088540822 | ||||||||
| Practice Location | |||||||||
| Address1: | 425 N LAKE AVE | ||||||||
| Address2: | |||||||||
| City: | WORCESTER | ||||||||
| State: | MA | ||||||||
| PostalCode: | 01605 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5085952513 | ||||||||
| FaxNumber: | 5088540822 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/10/2006 | ||||||||
| LastUpdateDate: | 02/20/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 38702 | MA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 3073319 | 05 | MA | MEDICAID | 7788601 | 01 | AETNA US HEALTHCARE | OTHER | 9900055 | 01 | FALLON COMM HEALTH PLAN | OTHER | AA1244 | 01 | HARVARD PILGRIM HLTHCARE | OTHER | 042472266 | 01 | PRIVATE HEALTHCARE SYST | OTHER | N01738 | 01 | BLUE CARE ELECT | OTHER | N01738 | 01 | BLUE SHIELD HMO BLUE | OTHER | N01738 | 01 | BLUE SHIELD INDEMNITY | OTHER | 042472266 | 01 | HEALTHCARE VALUE MGMT | OTHER | 2039834 | 01 | FIRST HEALTH | OTHER | 3073319 | 01 | MEDICAID/WELFARE | OTHER | 4042968 | 01 | CIGNA HEALTH PLAN | OTHER | N01738 | 01 | MEDICARE B | OTHER | 0401696 | 01 | EVERCARE | OTHER | 042472266 | 01 | ONE HEALTH PLAN | OTHER | 27142 | 01 | CHILDRENS MED SEC PLAN | OTHER | 27142 | 01 | HEALTHY START | OTHER | 784177 | 01 | MVP HEALTH CARE | OTHER |