Provider Demographics
NPI:1922172519
Name:ATG MASSACHUSETTS INC
Entity Type:Organization
Organization Name:ATG MASSACHUSETTS INC
Other - Org Name:NUMOTION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING AND LICENSURE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:WALTER
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-447-7515
Mailing Address - Street 1:805 BROOK ST STE 402
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-3431
Mailing Address - Country:US
Mailing Address - Phone:314-447-7500
Mailing Address - Fax:
Practice Address - Street 1:300 MYLES STANDISH BLVD STE 5
Practice Address - Street 2:
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-7364
Practice Address - Country:US
Practice Address - Phone:508-436-7414
Practice Address - Fax:508-436-7420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-17
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1540009OtherMEDICAL SERVICES COMPANY
MA699380OtherTUFTS HEALTH PLANS
MA699380OtherUS FAMILY HEALTH PLAN
MA20968OtherNEIGHBORHOOD HEALTH PLAN
MA2573958OtherAETNA
MA392654OtherBC BS MASSACHUSETTS
CT799116-G244OtherCONNECTICARE
MA1540009Medicaid
MA21192OtherBMC HEALTHNET PLAN
MA1530119OtherMEDICAID HOSPICE PROGRAM
MA702257OtherHARVARD PILGRIM HEALTHCAR
MA699380OtherUS FAMILY HEALTH PLAN
MA2573958OtherAETNA
MA3949300001Medicare NSC