NPIMap

Organization Active NPI

Fitchburg Adult Medicine LLC

  • Health Service Clinic/Center
  • Fitchburg, MA
National Provider Identifier
1073647855
Registry record updated Jan 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
45633 Issued in MA
Legal business name
FITCHBURG ADULT MEDICINE LLC
Practice address
76 Summer St
Suite 230
Fitchburg, MA 01420-5783
Phone
(978) 342-6018
Fax
(978) 343-4281
NPI assigned
Mar 15, 2007
Last updated
Jan 28, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2008

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

Authorized official

Name
Dr. Raymond Edward Wolejko, MDNPI 1487645495
Title
Managing Partner
Phone
(978) 342-6018

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 45633 MA Primary

Addresses

Primary practice location

76 Summer St
Suite 230
Fitchburg, MA 01420-5783

Mailing address

76 Summer St
Suite 230
Fitchburg, MA 01420-5783
Phone (978) 342-6018

Other identifiers 2

IdentifierTypeStateIssuer
0003445OtherMAMEDICARE PTAN
9709029MedicaidMA

National Provider Directory

National Provider Directory

Locations

76 Summer St
Ste 230
Fitchburg, MA 01420
Phone (978) 342-6018

Practitioners & affiliated clinicians

Practitioners 7

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": "1173916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201478400000",
    "number": "1073647855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 SUMMER ST",
            "address_2": "SUITE 230",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014205783",
            "telephone_number": "978-342-6018",
            "fax_number": "978-343-4281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 SUMMER ST",
            "address_2": "SUITE 230",
            "city": "FITCHBURG",
            "state": "MA",
            "postal_code": "014205783",
            "telephone_number": "978-342-6018",
            "fax_number": "978-343-4281"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FITCHBURG ADULT MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-15",
        "last_updated": "2008-01-28",
        "status": "A",
        "authorized_official_last_name": "WOLEJKO",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "978-342-6018",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "MA",
            "license": "45633",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "0003445",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9709029",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fitchburg, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.