Provider Demographics
| NPI: | 1487983342 |
|---|---|
| Name: | NEW HORIZONS MEDICAL, INC. |
| Entity type: | Organization |
| Organization Name: | NEW HORIZONS MEDICAL, INC. |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | DIRECTOR |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | OXANA |
| Authorized Official - Middle Name: | |
| Authorized Official - Last Name: | ANTONEVICH |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | PARTNER |
| Authorized Official - Phone: | 617-202-9222 |
| Mailing Address - Street 1: | 214 HOWARD ST |
| Mailing Address - Street 2: | |
| Mailing Address - City: | FRAMINGHAM |
| Mailing Address - State: | MA |
| Mailing Address - Zip Code: | 01702-8311 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | 508-872-0700 |
| Mailing Address - Fax: | 508-872-0773 |
| Practice Address - Street 1: | 214 HOWARD ST |
| Practice Address - Street 2: | |
| Practice Address - City: | FRAMINGHAM |
| Practice Address - State: | MA |
| Practice Address - Zip Code: | 01702-8311 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 508-872-0700 |
| Practice Address - Fax: | 508-872-0773 |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2009-12-23 |
| Last Update Date: | 2025-02-25 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Licenses
| State | License ID | Taxonomies |
|---|---|---|
| 101YM0800X, 163WP0808X, 2084A0401X, 261Q00000X, 261QM1300X, 261QR0405X, 101YA0400X | ||
| MA | 1027846 | 1041C0700X |
| MA | 239893 | 207Q00000X |
| MA | 31597 | 207R00000X |
| MA | 36288 | 207ZP0102X |
| MA | 223037 | 208100000X |
| MA | 80808 | 2083X0100X |
| MA | 227760 | 2084N0400X |
| MA | 49416 | 2085R0202X |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 101YA0400X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | Group - Multi-Specialty |
| No | 101YM0800X | Behavioral Health & Social Service Providers | Counselor | Mental Health | Group - Multi-Specialty |
| No | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |
| No | 163WP0808X | Nursing Service Providers | Registered Nurse | Psychiatric/Mental Health | Group - Multi-Specialty |
| No | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | Group - Multi-Specialty | |
| No | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
| No | 207ZP0102X | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology | Group - Multi-Specialty |
| No | 208100000X | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Group - Multi-Specialty | |
| No | 2083X0100X | Allopathic & Osteopathic Physicians | Preventive Medicine | Occupational Medicine | Group - Multi-Specialty |
| No | 2084A0401X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Addiction Medicine | Group - Multi-Specialty |
| No | 2084N0400X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | Group - Multi-Specialty |
| No | 2085R0202X | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology | Group - Multi-Specialty |
| No | 261Q00000X | Ambulatory Health Care Facilities | Clinic/Center | Group - Multi-Specialty | |
| No | 261QM1300X | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty | Group - Multi-Specialty |
| No | 261QR0405X | Ambulatory Health Care Facilities | Clinic/Center | Rehabilitation, Substance Use Disorder |
Provider Identifiers
| State | Identifier ID | ID Type | Issuer |
|---|---|---|---|
| MA | 110085003B | Medicaid | |
| MA | 110085003C | Medicaid | |
| MA | 110085003E | Medicaid | |
| MA | 110085003A | Medicaid | |
| MA | 110085003F | Medicaid | |
| MA | 110085003D | Medicaid |
