NPIMap

Organization Active NPI

MW Radiology-Cra LLC

  • Diagnostic Radiology Physician
  • Melrose, MA
National Provider Identifier
1114555398
Registry record updated Jul 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
MW RADIOLOGY-CRA LLC
Practice address
585 Lebanon St
Melrose, MA 02176-3225
Phone
(781) 979-3000
NPI assigned
Apr 1, 2020
Last updated
Jul 10, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2020

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

Authorized official

Name
Allan HoffmanNPI 1689668410
Title
MD
Phone
(610) 457-7964

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 Radiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2085R0202X Primary

Addresses

Primary practice location

585 Lebanon St
Melrose, MA 02176-3225

Mailing address

1342 Belmont St
Brockton, MA 02301-4436

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, WV, FL, WA, CA, RI, NH, ME8 enrollments

Enrollment records 8

Enrollment IDStateProvider typePAC IDDetails
O20200716000148 MA Part B Supplier - Clinic/Group Practice 6406270040 Receives reassigned benefits from 78 practitioners
Practice locations: Needham, MA; Groton, MA; Harvard, MA; Lexington, MA; Lynn, MA; Lynnfield, MA; Manchester by the Sea, MA; Melrose, MA…
O20230124003383 WV Part B Supplier - Clinic/Group Practice 6406270040 Receives reassigned benefits from 1 practitioner
Practice locations: Charleston, WV
O20230214002477 FL Part B Supplier - Clinic/Group Practice 6406270040 Receives reassigned benefits from 1 practitioner
Practice locations: Fort Lauderdale, FL
O20230802001158 WA Part B Supplier - Clinic/Group Practice 6406270040 Receives reassigned benefits from 1 practitioner
Practice locations: Seattle, WA; Washougal, WA
O20231025003698 CA Part B Supplier - Clinic/Group Practice 6406270040 Receives reassigned benefits from 3 practitioners
Practice locations: San Francisco, CA; Los Altos, CA; Palo Alto, CA
O20231130001923 RI Part B Supplier - Clinic/Group Practice 6406270040 Receives reassigned benefits from 1 practitioner
Practice locations: Providence, RI
O20240215000770 NH Part B Supplier - Clinic/Group Practice 6406270040 Receives reassigned benefits from 1 practitioner
Practice locations: Exeter, NH; Rye, NH
O20240228002670 ME Part B Supplier - Clinic/Group Practice 6406270040 Receives reassigned benefits from 2 practitioners
Practice locations: Eliot, ME; Portland, ME; York, ME

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1342 Belmont St
Brockton, MA 02301
Phone (508) 580-3330

Practitioners & affiliated clinicians

Practitioners 88

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 88

NPI Registry JSON

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

{
    "created_epoch": "1585699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594339200000",
    "number": "1114555398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1342 BELMONT ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023014436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 LEBANON ST",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "021763225",
            "telephone_number": "781-979-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MW RADIOLOGY-CRA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-01",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A",
        "authorized_official_last_name": "HOFFMAN",
        "authorized_official_first_name": "ALLAN",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "610-457-7964"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2020; 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.