NPIMap

Organization Active NPI

Middlesex Recovery, P.C.

  • Addiction Medicine (Preventive Medicine) Physician
  • Salem, NH
National Provider Identifier
1033712179
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Medicine (Preventive Medicine) PhysicianTaxonomy code 2083A0300X
Legal business name
MIDDLESEX RECOVERY, P.C.
Practice address
45 Stiles Rd Ste 206
Salem, NH 03079-2851
Phone
(603) 824-6937
NPI assigned
Nov 20, 2020
Last updated
Jul 29, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Authorized official

Name
Bruce Jarvie
Title
VP, Treasurer
Phone
(214) 379-3300

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X NU
Addiction Medicine (Preventive Medicine) Physician 2083A0300X NU Primary

Addresses

Primary practice location

45 Stiles Rd Ste 206
Salem, NH 03079-2851

Mailing address

20 Tower Office Park
Woburn, MA 01801-2113

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240105002908 NH Part B Supplier - Clinic/Group Practice 5698933216 Receives reassigned benefits from 2 practitioners
Practice locations: Salem, NH

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory
Tax ID family
Middlesex Recovery PC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

2 Courthouse Ln
Ste 2
Chelmsford, MA 01824
Phone (978) 275-9444

405 Pearl St
Ste 4
Malden, MA 02148
Phone (781) 605-0944

20 Tower Office Park
Woburn, MA 01801
Phone (781) 305-3300

53 Cummings Park
Woburn, MA 01801
Phone (339) 999-2722

45 Stiles Rd
Ste 206
Salem, NH 03079
Phone (603) 824-6937

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1605830400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1722211200000",
    "number": "1033712179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 TOWER OFFICE PARK",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018012113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 STILES RD STE 206",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030792851",
            "telephone_number": "603-824-6937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLESEX RECOVERY, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-20",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A",
        "authorized_official_last_name": "JARVIE",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_title_or_position": "VP, TREASURER",
        "authorized_official_telephone_number": "214-379-3300"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2083A0300X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Addiction Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.