NPIMap

Organization Active NPI

GL Pediatrics Inc

Doing business as Greater Lowellpediatrics,Inc.

  • Pediatrics Physician
  • Lowell, MA
National Provider Identifier
1003988346
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
Legal business name
GL PEDIATRICS INC
Doing business as
Greater Lowellpediatrics,Inc.
Practice address
33 Bartlett St
Suite 305
Lowell, MA 01852-1334
Phone
(978) 452-2200
Fax
(978) 441-2550
NPI assigned
Nov 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Peter Bousios
Title
Practice Administrator
Phone
(978) 452-2200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208000000X Primary

Addresses

Primary practice location

33 Bartlett St
Suite 305
Lowell, MA 01852-1334

Mailing address

33 Bartlett St
Suite 305
Lowell, MA 01852-1334
Phone (978) 452-2200

Other identifiers 2

IdentifierTypeStateIssuer
M16979OtherMABYBS
110072646AMedicaidMA

Other names 1

  • GREATER LOWELLPEDIATRICS,INC. Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050614000141 MA Part B Supplier - Clinic/Group Practice 2264476019 Receives reassigned benefits from 2 practitioners
Practice locations: Lowell, MA

National Provider Directory

National Provider Directory

Locations

33 Bartlett St
Ste 305
Lowell, MA 01852
Phone (978) 452-2200

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1716422400000",
    "number": "1003988346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33 BARTLETT ST",
            "address_2": "SUITE 305",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018521334",
            "telephone_number": "978-452-2200",
            "fax_number": "978-441-2550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33 BARTLETT ST",
            "address_2": "SUITE 305",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018521334",
            "telephone_number": "978-452-2200",
            "fax_number": "978-441-2550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GL PEDIATRICS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A",
        "authorized_official_last_name": "BOUSIOS",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "PRACTICE ADMINISTRATOR",
        "authorized_official_telephone_number": "978-452-2200"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BYBS",
            "identifier": "M16979",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110072646A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GREATER LOWELLPEDIATRICS,INC.",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GREATER LOWELLPEDIATRICS,INC.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lowell, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.