NPIMap

Individual provider Active NPI

Mark Henry, MD

  • Urology Physician
  • Chelmsford, MA
National Provider Identifier
1104211333
Registry record updated Apr 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
282116 Issued in MA
Practice address
31 Village SQ
Chelmsford, MA 01824-2712
Phone
(978) 256-9507
Fax
(978) 256-6955
NPI assigned
Apr 3, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208800000X 282116 MA Primary

Addresses

Primary practice location

31 Village SQ
Chelmsford, MA 01824-2712

Mailing address

31 Village SQ
Chelmsford, MA 01824-2712
Phone (978) 256-9507

Other practice location 1

41 Mall Rd
Burlington, MA 01805-2712
Phone (781) 744-8000

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
I20200803001554 MA Practitioner - Urology 3072817303 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Tufts University School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lahey Clinic IncGroup PAC ID 2264336528, shared by 3 NPIs, 1,381 clinicians

Practice addresses (Care Compare)

1 Essex Ctr Dr
Peabody, MA 01960-2901
Phone (978) 538-4000

29 Mall Rd
Burlington, MA 01805-0001

41 Mall Rd
Burlington, MA 01805-0001

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
282116MAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lahey Clinic, Inc Single Specialty CurrentSince Mar 1, 2023 Accepting new patients
Lahey Clinic, Inc. Single Specialty CurrentSince Mar 1, 2023 Accepting new patients
LGH Professional Services LLC Single Specialty Past Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

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

1 Essex Dr
Peabody, MA 01960
Phone (978) 538-4000

Interoperability endpoints

  • Direct secure messaging: mhenry199574@direct.bilh.masshiway.net

Organizations & group practices 3

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 7

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": "1428019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682553600000",
    "number": "1104211333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 VILLAGE SQ",
            "city": "CHELMSFORD",
            "state": "MA",
            "postal_code": "018242712",
            "telephone_number": "978-256-9507",
            "fax_number": "978-256-6955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 VILLAGE SQ",
            "city": "CHELMSFORD",
            "state": "MA",
            "postal_code": "018242712",
            "telephone_number": "978-256-9507",
            "fax_number": "978-256-6955"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Mall Rd",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "MA",
            "postal_code": "018052712",
            "country_code": "US",
            "telephone_number": "781-744-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HENRY",
        "first_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-03",
        "last_updated": "2023-04-27",
        "certification_date": "2023-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "MA",
            "license": "282116",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chelmsford, MA

Sources for this page

Verify at the official NPI Registry.