Organization Active NPI

James P. Bresnahan, P.C.

  • Addiction (Substance Use Disorder) Counselor
  • Worcester, MA
National Provider Identifier
1023289782
Registry record updated Mar 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
4524 Issued in MA
Legal business name
JAMES P. BRESNAHAN, P.C.
Practice address
55 Cedar St
Worcester, MA 01609-4101
Phone
(508) 752-1170
Fax
(508) 752-1800
NPI assigned
Mar 20, 2008
Last updated
Mar 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2008

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

Authorized official

Name
Mr. James Patrick Bresnahan Jr., M.ED.NPI 1215031802
Title
Owner
Phone
(508) 752-1170

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 4524 MA Primary

Addresses

Primary practice location

55 Cedar St
Worcester, MA 01609-4101

Mailing address

55 Cedar St
Worcester, MA 01609-4101
Phone (508) 752-1170

Other identifiers 2

IdentifierTypeStateIssuer
1306421MedicaidMA
Y10400OtherMA1308785, 2220002001

Other names 1

  • James P. Bresnahan Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240529003836 MA Part B Supplier - Clinic/Group Practice 5193167682 Receives reassigned benefits from 1 practitioner
Practice locations: Worcester, MA

National Provider Directory

National Provider Directory

Locations

50 Elm St
Worcester, MA 01609
Phone (508) 752-1170

50 Elm St
Ste 7B
Worcester, MA 01609
Phone (508) 752-1170

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1205971200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205971200000",
    "number": "1023289782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 CEDAR ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016094101",
            "telephone_number": "508-752-1170",
            "fax_number": "508-752-1800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 CEDAR ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016094101",
            "telephone_number": "508-752-1170",
            "fax_number": "508-752-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES P. BRESNAHAN, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-20",
        "last_updated": "2008-03-20",
        "status": "A",
        "authorized_official_last_name": "BRESNAHAN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "508-752-1170",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.ED."
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "4524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306421",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "1308785, 2220002001",
            "identifier": "Y10400",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "James P. Bresnahan",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2008; 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.