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WELLSPACE PRIMARY CARE PLLC
NPI 1104647817
Family Medicine in Wellesley, MA

Active since October 24, 2024CLIA 22D2331470 · Waiver
65 WALNUT ST STE 500, WELLESLEY, MA 02481(781) 304-8236 Get Directions Write a Review

NPPES record last updated: February 13, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Wellspace Primary Care Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

WELLSPACE PRIMARY CARE PLLC (NPI 1104647817) is a healthcare organization registered as a family medicine in Wellesley, Massachusetts and active in the NPI registry since October 2024. The organization holds a CLIA Waiver certificate valid through October 1, 2027 and lists Michael David Dick, Family Medicine Physician, as its authorized official.

NPPES Registry Identity

NPI1104647817
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameWELLSPACE PRIMARY CARE PLLC
Location Address65 WALNUT ST STE 500Wellesley, MA 02481-2112
Mailing Address10 Cumberland RdBelmont, MA 02478-2111 · (714) 553-3887
Phone(781) 304-8236
Organization SubpartNo
Authorized OfficialMichael David DickFamily Medicine Physician · (714) 553-3887
Enumeration DateOctober 24, 2024
Last NPPES UpdateFebruary 13, 2025
NPPES CertifiedFebruary 13, 2025
✔ NPI 1104647817 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
65 WALNUT ST STE 500, Wellesley, MA 02481
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 22D2331470

Wellspace Primary Care PLLC · Wellesley, MA
Active · expires Oct 1, 2027
CLIA Number22D2331470
Laboratory TypePhysician Office
Certificate Effective DateOctober 2, 2025
Certificate Expiration DateOctober 1, 2027
Laboratory DirectorMichael D. Dick
Laboratory Phone(781) 705-2200
Laboratory LocationWellspace Primary Care PLLC70 Walnut Street Floor 2, Wellesley, MA 02481
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Wellspace Primary Care PLLC's NPI number?

The NPI number for Wellspace Primary Care PLLC is 1104647817. It was assigned to this organization in the NPPES registry on October 24, 2024.

Where is Wellspace Primary Care PLLC located?

Wellspace Primary Care PLLC is located at 65 Walnut St Ste 500, Wellesley, MA 02481. The listed phone number is (781) 304-8236.

What is Wellspace Primary Care PLLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Wellspace Primary Care PLLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 22D2331470) is associated with this NPI, valid through October 1, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Wellspace Primary Care PLLC was last updated on February 13, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.