Organization Active NPI

Neurocare, Inc.

  • Sleep Disorder Diagnostic Clinic/Center
  • Newton, MA
National Provider Identifier
1124011440
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sleep Disorder Diagnostic Clinic/CenterTaxonomy code 261QS1200X
Legal business name
NEUROCARE, INC.
Practice address
70 Wells Ave
Suite 201
Newton, MA 02459-3210
Phone
(617) 796-7766
Fax
(617) 796-9099
NPI assigned
Aug 23, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Mr. William Robert Mayer
Title
Controller
Phone
(617) 796-7766

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sleep Disorder Diagnostic Clinic/Center 261QS1200X Primary

Addresses

Primary practice location

70 Wells Ave
Suite 201
Newton, MA 02459-3210

Mailing address

70 Wells Ave
Suite 201
Newton, MA 02459-3210
Phone (617) 796-7766

Other identifiers 4

IdentifierTypeStateIssuer
603116OtherMAHARVARDPILGRIMHEALTHCARE
0577845OtherMAAETNA US HEALTHCARE
SF038269OtherMABCBS OF MA
713709OtherMATUFTS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050110000430 MA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 2365490034 Practice locations: Newton, MA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D1024185Neurocare Inc70 Wells Avenue Suite 101, Newton, MA 02459Certificate of waiverApr 4, 2028

National Provider Directory

National Provider Directory
Tax ID family
Neurocare Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

70 Wells Ave
Newton, MA 02459

70 Wells Ave
Ste 201
Newton, MA 02459
Phone (617) 796-7766

70 Wells Ave
Ste 101
Newton Center, MA 02459
Phone (617) 581-6401

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1124011440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 WELLS AVE",
            "address_2": "SUITE 201",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024593210",
            "telephone_number": "617-796-7766",
            "fax_number": "617-796-9099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 WELLS AVE",
            "address_2": "SUITE 201",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024593210",
            "telephone_number": "617-796-7766",
            "fax_number": "617-796-9099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEUROCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-23",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "MAYER",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "CONTROLLER",
        "authorized_official_telephone_number": "617-796-7766",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QS1200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Sleep Disorder Diagnostic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARDPILGRIMHEALTHCARE",
            "identifier": "603116",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "0577845",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MA",
            "identifier": "SF038269",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "713709",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.