NPIMap

Organization Active NPI

Northeast Urologic Surgery, PC

  • Urology Physician
  • North Andover, MA
National Provider Identifier
1053361352
Registry record updated Mar 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
Legal business name
NORTHEAST UROLOGIC SURGERY, PC
Practice address
231 Sutton St
Ste 1D
North Andover, MA 01845-1620
Phone
(978) 686-3877
Fax
(978) 686-9586
NPI assigned
May 10, 2006
Last updated
Mar 15, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 15, 2013

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

Authorized official

Name
Dr. Steven Robert Previte, MDNPI 1134178890
Title
President
Phone
(978) 686-3877

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
Urology Physician 208800000X NU Primary

Addresses

Primary practice location

231 Sutton St
Ste 1D
North Andover, MA 01845-1620

Mailing address

231 Sutton St
Ste 1D
North Andover, MA 01845
Phone (978) 686-3877

Other identifiers 2

IdentifierTypeStateIssuer
99904764MedicaidNH
9719911MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040712000706 NH Part B Supplier - Clinic/Group Practice 9638154016 Receives reassigned benefits from 5 practitioners
Practice locations: Salem, NH
O20080228000145 MA Part B Supplier - Clinic/Group Practice 9638154016 Receives reassigned benefits from 16 practitioners
Practice locations: North Andover, MA

National Provider Directory

National Provider Directory

Locations

231 Sutton St
#D
North Andover, MA 01845

231 Sutton St
Unit D
North Andover, MA 01845

565 Turnpike St
Ste 8687
North Andover, MA 01845

23 Stiles Rd
Ste 109
Salem, NH 03079
Phone (603) 425-9564

Interoperability endpoints

  • Direct secure messaging: christopherip@neurosurg.medalliesdirect.net
  • Direct secure messaging: georgecanellakis@neurosurg.medalliesdirect.net
  • Direct secure messaging: ossamasakr@neurosurg.medalliesdirect.net
  • Direct secure messaging: stevenprevite@neurosurg.medalliesdirect.net
  • Direct secure messaging: teodorakurteva@neurosurg.medalliesdirect.net

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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": "1147219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363305600000",
    "number": "1053361352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "231 SUTTON ST",
            "address_2": "STE 1D",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "01845",
            "telephone_number": "978-686-3877",
            "fax_number": "978-686-9586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "231 SUTTON ST",
            "address_2": "STE 1D",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018451620",
            "telephone_number": "978-686-3877",
            "fax_number": "978-686-9586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST UROLOGIC SURGERY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-10",
        "last_updated": "2013-03-15",
        "status": "A",
        "authorized_official_last_name": "PREVITE",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-686-3877",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "99904764",
            "state": "NH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9719911",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Andover, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2013; 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.