NPIMap

Organization Active NPI

Sun Medical Clinic, PC

  • Health Service Clinic/Center
  • Leominster, MA
National Provider Identifier
1053510180
Registry record updated Jul 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
232981 Issued in MA
Legal business name
SUN MEDICAL CLINIC, PC
Practice address
50 Memorial Dr
Suite 110
Leominster, MA 01453-2238
Phone
(978) 840-0055
Fax
(978) 840-0063
NPI assigned
Jul 18, 2007
Last updated
Jul 18, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2007

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

Authorized official

Name
Dr. Ralph E Spada, M.D.NPI 1639376577
Title
President
Phone
(978) 840-0055

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
Health Service Clinic/Center 261QH0100X 232981 MA Primary

Addresses

Primary practice location

50 Memorial Dr
Suite 110
Leominster, MA 01453-2238

Mailing address

50 Memorial Dr
Suite 110
Leominster, MA 01453-2238
Phone (978) 840-0055

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070917000557 MA Part B Supplier - Clinic/Group Practice 8921192386 Receives reassigned benefits from 1 practitioner
Practice locations: Leominster, MA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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": "1184716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184716800000",
    "number": "1053510180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 MEMORIAL DR",
            "address_2": "SUITE 110",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014532238",
            "telephone_number": "978-840-0055",
            "fax_number": "978-840-0063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MEMORIAL DR",
            "address_2": "SUITE 110",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014532238",
            "telephone_number": "978-840-0055",
            "fax_number": "978-840-0063"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUN MEDICAL CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-18",
        "last_updated": "2007-07-18",
        "status": "A",
        "authorized_official_last_name": "SPADA",
        "authorized_official_first_name": "RALPH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-840-0055",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "MA",
            "license": "232981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leominster, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; 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.