MEDICARE: SLEEPMED

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QS1200X	Sleep Disorder Diagnostic Clinic/Center

General Provider Information

NPI Number	:	1487646402
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SLEEPMED

Provider Business Mailing Address
First Line	:	200 CORPORATE PL
Second Line	:
City	:	PEABODY
State	:	MA
Zip	:	01960-3840
Country	:	US
Telephone Number	:	978-536-7400
Fax Number	:	978-535-9778

Provider Business Practice Location Address
First Line	:	200 CORPORATE PL
Second Line	:
City	:	PEABODY
State	:	MA
Zip	:	01960-3840
Country	:	US
Telephone Number	:	978-536-7400
Fax Number	:	978-535-9778

Authorized Official
Title or Position	:	EVP/CFO
Name	:	MR. CARL IBERGER
Credential	:
Telephone Number	:	978-536-6105

Provider Enumeration Date	:	08/16/2005
Last Update Date	:	08/22/2020

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Practice Location Address:

200 CORPORATE PL STE 6A
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01960-3840

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1780672162 — DR. JULIA ANDREA ELVIN MD, PHD
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200 CORPORATE PL , SUITE 7
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1508833641 — KATHLEEN TROTTA MD
Practice Location Address:

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1932177466 — CYTODX LLC
Practice Location Address:

200 CORPORATE PL
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1578532628 — JAMES HARTEN MD
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Directions to “SLEEPMED ” Practice Location

Language	Start Address	Practice Location

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