NPIMap

Individual provider Active NPI

Riad Ettunsi

  • Internal Medicine Physician
  • Lowell, MA
National Provider Identifier
1073828893
Registry record updated Feb 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
254793 Issued in MA
Practice address
295 Varnum Ave
Lowell, MA 01854-2134
Phone
(978) 937-6000
NPI assigned
Aug 17, 2010
Last updated
Feb 7, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 254793 MA Primary

Addresses

Primary practice location

295 Varnum Ave
Lowell, MA 01854-2134

Mailing address

295 Varnum Ave
Lowell, MA 01854-2134

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140328001457 MA Practitioner - Internal Medicine 4688805906 Reassigns benefits to 9 organizations
I20240729004229 NH Practitioner - Internal Medicine 4688805906 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lawrence General HospitalGroup PAC ID 5092725200, 124 clinicians
Community Medical Associates, Inc.Group PAC ID 6002946928, 155 clinicians

Practice addresses (Care Compare)

1 General St
Lawrence, MA 01841-2961
Phone 97868340002979

70 E St
Methuen, MA 01844-4597
Phone (978) 687-0151

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Mill City Medical Group LTD Internal Medicine CurrentSince Dec 6, 2021 Accepting new patients
Winchester Hospital Inpatient Specialists PLLC Internal Medicine CurrentSince May 30, 2017 Accepting new patients
Community Medical Associates, Inc. CurrentSince Oct 1, 2024 Accepting new patients
Winchester Lahey Inpatient Specialists PLLC Internal Medicine CurrentSince Aug 2, 2017 Accepting new patients
Revere Medical of Massachusetts, PC Internal Medicine CurrentSince Dec 23, 2024 Accepting new patients
Steward Medical Group, Inc CurrentSince Apr 1, 2019 Accepting new patients
Steward Medical Group, Inc CurrentSince Apr 1, 2019 Accepting new patients
Physicians of Cape Cod Hospital Internal Medicine CurrentSince Jul 31, 2019 Accepting new patients
Lawrence General Hospital Internal Medicine Current Accepting new patients
Lawrence General Hospital CurrentSince Oct 20, 2025 Accepting new patients
LGH Medical Group, Inc. Past Accepting new patients
LG Newcorp Inc Past Accepting new patients

Locations

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

1 Pearl St
Ste 1000
Brockton, MA 02301
Phone (508) 897-6050

290 Littleton Rd
Unit 3
Chelmsford, MA 01824
Phone (978) 258-4734

15 Payson Rd
Ste 3
Foxboro, MA 02035
Phone (508) 772-1438

140 Lincoln Ave
Haverhill, MA 01830
Phone (978) 374-2000

27 Park St
Hyannis, MA 02601
Phone (508) 775-5011

1 General St
Lawrence, MA 01841
Phone (978) 946-8103

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

295 Varnum Ave
Lowell, MA 01854
Phone (978) 788-7344

595 Pawtucket Blvd
Ste 2
Lowell, MA 01854
Phone (978) 459-8447

60 East St
Ste 2200
Methuen, MA 01844
Phone (978) 683-9177

70 East St
Methuen, MA 01844
Phone (978) 682-1906

47 High St
Ste 101
North Andover, MA 01845
Phone (978) 258-4734

18 Main St
Ste 104
Townsend, MA 01469
Phone (978) 597-9091

35 United Dr
Ste 102
West Bridgewater, MA 02379

41 Highland Ave
Winchester, MA 01890
Phone (781) 756-2000

22 Keewaydin Dr
Salem, NH 03079
Phone (603) 685-6977

1 Harbison Way
Ste 222
Columbia, SC 29212

Organizations & group practices 12

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1282003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1486425600000",
    "number": "1073828893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "295 VARNUM AVE",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018542134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 VARNUM AVE",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018542134",
            "telephone_number": "978-937-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETTUNSI",
        "first_name": "RIAD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-17",
        "last_updated": "2017-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "254793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

Verify at the official NPI Registry.