Provider Demographics
NPI:1083661318
Name:POURATI, ISAAC (MD)
Entity Type:Individual
Prefix:
First Name:ISAAC
Middle Name:
Last Name:POURATI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 MERRIMAC ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-2192
Mailing Address - Country:US
Mailing Address - Phone:978-499-7400
Mailing Address - Fax:978-499-7335
Practice Address - Street 1:260 MERRIMAC ST
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-2192
Practice Address - Country:US
Practice Address - Phone:978-499-7400
Practice Address - Fax:978-499-7335
Is Sole Proprietor?:No
Enumeration Date:2006-05-30
Last Update Date:2012-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA212177207RC0000X, 207R00000X, 207UN0901X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1083661318OtherAETNA HMO
MA1083661318OtherFALLON COMMUNITY HEALTH PLAN
MAH70269OtherANTHEM BS
MA25-14031OtherEVERCARE
MAJ41262OtherBLUE CROSS
MA7500893OtherAETNA NON HMO
MA110075439AMedicaid
NH30206639OtherNH MEDICAID
MA7294935OtherCIGNA
MA1083661318OtherPHCS
MA1083661318OtherUNITED HEALTHCARE
495762OtherTUFTS
MDAA83892OtherHPHC
MAJ41262OtherBLUE CROSS
H720269Medicare UPIN