Organization
CAMBRIDGE HEALTH ALLIANCE PHYSICIANS ORGANIZATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVE PORELL (CAO)
(617) 499-6621
Entity
Organization
Contact information
Practice address
1493 CAMBRIDGE ST, CAMBRIDGE, MA 02139-1047
(617) 665-1000
Mailing address
1493 CAMBRIDGE ST, CAMBRIDGE, MA 02139-1047
(617) 665-1000
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207W00000X
Ophthalmology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
—
—
208000000X
Pediatrics Physician
Primary
—
—
2081H0002X
Hospice and Palliative Medicine (Physical Medicine & Rehabilitation) Physician
—
—
2084P0800X
Psychiatry Physician
—
—
2085R0202X
Diagnostic Radiology Physician
—
—
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9779043
—
MA
05
—
9779159
—
MA
01
—
M15404
BCBS LEGACY GROUP NUMBER
MA
01
—
M18077
BCBS LEGACY GROUP NUMBER
MA
Enumeration date
05/09/2007
Last updated
09/11/2025
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