NPIMap

Individual provider Active NPI

Andrew Ernest Bennett, M.D., PH.D.

  • Diagnostic Radiology Physician
  • Worcester, MA
National Provider Identifier
1104067966
Registry record updated Nov 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
235534 Issued in MA
Practice address
55 Lake Ave North
Worcester, MA 01655-0002
Phone
(508) 334-3850
Fax
(508) 334-9108
NPI assigned
Mar 9, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 235534 MA Primary

Addresses

Primary practice location

55 Lake Ave North
Worcester, MA 01655-0002

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885

Other practice location 1

1 General St
L & M Radiology, Inc.
Lawrence, MA 01841-2961
Phone (978) 946-8103

Other identifiers 2

IdentifierTypeStateIssuer
110083413AMedicaidMA
11969099OtherMACAQH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090625000626 MA Practitioner - Diagnostic Radiology 9032260393 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Harvard Medical School, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Umass Memorial Medical Group Inc 2,494 clinicians

Practice addresses (Care Compare)

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000

Hospital & facility affiliations

  • Umass Memorial Medical Center/University Campus Hospital, Worcester, MA, CCN 220163
  • Umass Memorial Healthalliance Hospitals Hospital, Leominster, MA, CCN 220001
  • Umass Memorial Health - Harrington Hospital Hospital, Southbridge, MA, CCN 220019
  • Marlborough Hospital Hospital, Marlborough, MA, CCN 220049
  • Milford Regional Medical Center Hospital, Milford, MA, CCN 220090

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
235534MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Apr 22, 2018 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Current Accepting new patients
Umass Memorial MRI & Imaging Center, LLC CurrentSince Feb 28, 2025 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Jul 1, 2009 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Dec 5, 2024 Accepting new patients
Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Ce Diagnostic Radiology CurrentSince Jul 1, 2009 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is CurrentSince Dec 15, 2018 Accepting new patients
Associated Physicians of Harvard Medical Faculty Physicians at Beth Is Diagnostic Radiology CurrentSince Dec 15, 2018 Accepting new patients
Umass Memorial MRI - Marlborough CurrentSince Feb 28, 2025 Accepting new patients
Umass Memorial Medical Group Inc CurrentSince Dec 5, 2024 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince Apr 22, 2018 Accepting new patients

Locations

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

10 N Main St
Charlton, MA 01507
Phone (508) 248-3015

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

1 General St
#L
Lawrence, MA 01841
Phone (508) 756-7300

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

14 Prospect St
Milford, MA 01757
Phone (508) 422-2343

275 Sandwich St
Plymouth, MA 02360
Phone (508) 746-2000

340 Thompson Rd
Webster, MA 01570
Phone (508) 943-2600

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

119 Belmont St
Worcester, MA 01605
Phone (508) 334-6345

Interoperability endpoints

  • Direct secure messaging: abennett254072@direct.bilh.masshiway.net

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 and National Provider Directory roles.

Hospital & facility affiliations 6

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": "1236556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731974400000",
    "number": "1104067966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885",
            "fax_number": "508-334-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE NORTH",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-334-3850",
            "fax_number": "508-334-9108"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 General St",
            "address_2": "L & M Radiology, Inc.",
            "address_purpose": "LOCATION",
            "city": "Lawrence",
            "state": "MA",
            "postal_code": "018412961",
            "country_code": "US",
            "telephone_number": "978-946-8103",
            "fax_number": "978-946-8067",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BENNETT",
        "first_name": "ANDREW",
        "middle_name": "ERNEST",
        "credential": "M.D., PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-09",
        "last_updated": "2024-11-19",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "235534",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110083413A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11969099",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.