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BETHEL MEDICAL GROUP PC
NPI 1861607558
Family Medicine in Brockton, MA

Active since May 14, 2007CLIA 22D0080387 · Waiver
111 TORREY ST, BROCKTON, MA 02301(508) 588-1200(508) 941-0497 Get Directions Write a Review

NPPES record last updated: April 4, 2016. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Bethel Medical Group Pc NPPES

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

BETHEL MEDICAL GROUP PC (NPI 1861607558) is a healthcare organization registered as a family medicine in Brockton, Massachusetts and active in the NPI registry since May 2007. The organization holds a CLIA Waiver certificate valid through March 8, 2028 and lists Douglas R Grogan, Ceo, as its authorized official.

NPPES Registry Identity

NPI1861607558
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameBETHEL MEDICAL GROUP PC
Location Address111 TORREY STBrockton, MA 02301-4800
Mailing AddressPo Box 848889Boston, MA 02284-8889 · (508) 588-1200 · Fax (508) 941-0497
Phone(508) 588-1200
Fax(508) 941-0497
Organization SubpartNo
Authorized OfficialDouglas R GroganCeo · (508) 588-1200
Enumeration DateMay 14, 2007
Last NPPES UpdateApril 4, 2016
✔ NPI 1861607558 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.
111 TORREY ST, Brockton, MA 02301
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Other Names 1

Doing Business AsBethel Medical Group Pc

Other Identifiers 1

Medicaid9780629MA

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

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

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 22D0080387

Bethel Medical Group · Brockton, MA
Active · expires Mar 8, 2028
CLIA Number22D0080387
Laboratory TypePhysician Office
Certificate Effective DateMarch 9, 2026
Certificate Expiration DateMarch 8, 2028
Laboratory DirectorDouglas R. Grogan
Laboratory Phone(508) 588-1200
Laboratory LocationBethel Medical Group111 Torrey St, Brockton, MA 02301
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MISS JESSICA CHANG LIM F.N.P.
Family Medicine
111 TORREY ST
BROCKTON, MA 02301
Plymouth County (508) 588-1200
DR. MICHAEL D KEEFE D.M.D.
Dentist (General Practice)
111 TORREY ST
BROCKTON, MA 02301
Plymouth County (508) 583-6253
STEPHEN FEARNLEY CADC
Counselor (Addiction (Substance Use Disorder))
111 TORREY ST, SUITE 3
BROCKTON, MA 02301
Plymouth County (508) 584-5190
CASSANDRA SCHMALL
Student in an Organized Health Care Education/Training Program
111 TORREY ST, #3
BROCKTON, MA 02301
Plymouth County (508) 584-5190
JENNIFER KAROUL FNP
Nurse Practitioner (Family)
111 TORREY ST
BROCKTON, MA 02301
Plymouth County (508) 588-1200
JOAN BURKE
Counselor
111 TORREY ST
BROCKTON, MA 02301
Plymouth County (508) 540-6550
DR. JENNIFER HALL DIFALCO M.D.
Family Medicine
111 TORREY ST
BROCKTON, MA 02301
Plymouth County (508) 588-1200
MR. MARK ANDREW SULLIVAN LICSW
Social Worker (Clinical)
111 TORREY ST
BROCKTON, MA 02301
Plymouth County (508) 584-5190

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 Bethel Medical Group PC's NPI number?

The NPI number for Bethel Medical Group PC is 1861607558. It was assigned to this organization in the NPPES registry on May 14, 2007.

Where is Bethel Medical Group PC located?

Bethel Medical Group PC is located at 111 Torrey St, Brockton, MA 02301. The listed phone number is (508) 588-1200.

What is Bethel Medical Group PC's specialty?

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

Does Bethel Medical Group PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 22D0080387) is associated with this NPI, valid through March 8, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Bethel Medical Group PC accept?

Health plans from Anthem Blue Cross and Blue Shield list Bethel Medical Group PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Bethel Medical Group PC was last updated on April 4, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years 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.