Mass General Brigham Medical Group Northern Massachusetts Inc

Organization Active NPI Clinical Medical Laboratory · Haverhill, MA

NPI 1033066972 · NPPES record last updated Mar 27, 2026

Key facts

NPI
1033066972
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Medical Laboratory 291U00000X
Legal business name
MASS GENERAL BRIGHAM MEDICAL GROUP NORTHERN MASSACHUSETTS INC
Practice address
1 Park Way
3Rd FL
Haverhill, MA 01830-6220
Phone
(978) 521-3200
NPI assigned
Mar 11, 2026
Organization subpart
No

Authorized official

Name
Joanna Hazell
Title
Director, Rco Provider Enrollment
Phone
(781) 254-4854

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 817

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

View all 817

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20260501000659 MA Part B Supplier - Independent Clinical Laboratory 3577467224 Practice locations: Haverhill, MA

National Provider Directory

Tax ID family
Charter Prof SVCS Corp (3 organizations share this tax ID)

Locations

399 Revolution Dr
Ste 580
Somerville, MA 02145

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Yes

Addresses

Primary practice location

1 Park Way
3Rd FL
Haverhill, MA 01830-6220

Mailing address

399 Revolution Dr Ste 580
Somerville, MA 02145-1572
Phone (781) 254-4865

Other names

  • MGB Pathology - PMA Lab Doing business as

Other providers in Haverhill, MA

All providers in Haverhill, MA · Clinical Medical Laboratory in Massachusetts

Sources for this page

Verify at the official NPI Registry.