BESPOKE PRIMARY CARE, PLLC
NPI 1396617114
Family Medicine in Wellesley, MA
About Bespoke Primary Care, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BESPOKE PRIMARY CARE, PLLC (NPI 1396617114) is a healthcare organization registered as a family medicine in Wellesley, Massachusetts and active in the NPI registry since September 2025. The organization holds a CLIA Waiver certificate valid through October 5, 2027 and lists Michael Richardson, Medical Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Bespoke Primary Care, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Bespoke Primary Care, PLLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 22D2331608
Bespoke Primary Care, LLC · Wellesley, MAFrequently 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 Bespoke Primary Care, PLLC's NPI number?
The NPI number for Bespoke Primary Care, PLLC is 1396617114. It was assigned to this organization in the NPPES registry on September 22, 2025.
Where is Bespoke Primary Care, PLLC located?
Bespoke Primary Care, PLLC is located at 60 Walnut St Bsmt, Wellesley, MA 02481. The listed phone number is (617) 531-9503.
What is Bespoke Primary Care, PLLC's specialty?
The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.
Is Bespoke Primary Care, PLLC enrolled in Medicare?
Yes. Bespoke Primary Care, PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Bespoke Primary Care, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Bespoke Primary Care, PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Bespoke Primary Care, PLLC hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 22D2331608) is associated with this NPI, valid through October 5, 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 Bespoke Primary Care, PLLC was last updated on September 22, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.
# Bespoke Primary Care, Pllc · NPI 1396617114
Family Medicine organization in Wellesley, Massachusetts. Organization record, active in the CMS NPPES registry since September 22, 2025.
## Identity
- **NPI:** 1396617114 (Entity type: Organization)
- **Enumerated:** September 22, 2025
- **Primary specialty:** Family Medicine · taxonomy 207Q00000X
- **Organization subpart:** No
- **Authorized official:** Michael Richardson, MEDICAL DIRECTOR
## Practice location
- **Address:** 60 WALNUT ST BSMT, Wellesley, MA 02481-2151
- **Phone:** (617) 531-9503
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Family Practice) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 22, 2025
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1396617114) · Data from the CMS NPPES public registry.