NPIMap

Organization Active NPI

North Bridge Imaging Group, LLC

  • Diagnostic Neuroimaging (Radiology) Physician
  • Concord, MA
National Provider Identifier
1093838195
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Neuroimaging (Radiology) PhysicianTaxonomy code 2085D0003X
Legal business name
NORTH BRIDGE IMAGING GROUP, LLC
Practice address
133 Old Road to 9 Acre Cor
Concord, MA 01742-4159
Phone
(978) 287-3700
NPI assigned
Apr 6, 2007
Last updated
Nov 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Authorized official

Name
Dr. David I. Rose, MDNPI 1477528677
Title
President
Phone
(978) 287-3794

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
Diagnostic Neuroimaging (Radiology) Physician 2085D0003X Primary

Addresses

Primary practice location

133 Old Road to 9 Acre Cor
Concord, MA 01742-4159

Mailing address

10 Little Brook Rd
West Wareham, MA 02576-1222
Phone (800) 841-5200

Other identifiers 1

IdentifierTypeStateIssuer
9716190MedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040305000846 MA Part B Supplier - Clinic/Group Practice 3577451178 Receives reassigned benefits from 20 practitioners
1 other NPI on this enrollment
Practice locations: Franklin, MA; Westford, MA; Sudbury, MA; Peabody, MA; Northbridge, MA; Milford, MA; Hopkinton, MA; Leominster, MA…

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

133 Littleton Rd
Westford, MA 01886
Phone (978) 589-6800

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 20

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 20

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1093838195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 LITTLE BROOK RD",
            "city": "WEST WAREHAM",
            "state": "MA",
            "postal_code": "025761222",
            "telephone_number": "800-841-5200",
            "fax_number": "508-273-1241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 OLD ROAD TO 9 ACRE COR",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017424159",
            "telephone_number": "978-287-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH BRIDGE IMAGING GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-06",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "I.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-287-3794",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085D0003X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Neuroimaging",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9716190",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Concord, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.