Individual provider Active NPI

Douglas W Laidlaw, M.D.

  • Clinical Cardiac Electrophysiology Physician
  • Worcester, MA
National Provider Identifier
1124167911
Registry record updated May 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Cardiac Electrophysiology PhysicianTaxonomy code 207RC0001X
License
220099 Issued in MA
Practice address
123 Summer St Ste 290N
Worcester, MA 01608-1216
Phone
(508) 368-3130
Fax
(508) 368-3167
NPI assigned
Feb 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cardiac Electrophysiology Physician 207RC0001X 220099 MA Primary
Cardiovascular Disease Physician 207RC0000X 220099 MA

Addresses

Primary practice location

123 Summer St Ste 290N
Worcester, MA 01608-1216

Mailing address

123 Summer St Ste 290N
Worcester, MA 01608-1216
Phone (508) 368-3130

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040816000855 MA Practitioner - Cardiac ElectrophysiologyPractitioner - Internal MedicinePractitioner - Cardiovascular Disease (Cardiology) 0244203578 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiac ElectrophysiologyAlso: Cardiovascular Disease (Cardiology)
Education
Icahn School of Medicine at Mount Sinai, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

123 Summer St
Worcester, MA 01608-1216
Phone (508) 363-5000

24 Newton St
Southborough, MA 01772-1215
Phone (508) 486-4472

5 Neponset St
Worcesteer, MA 01606-2714
Phone (508) 595-2300

Hospital & facility affiliations

  • St Vincent Hospital Hospital, Worcester, MA, CCN 220176

Procedures performed for Medicare patients

ProcedureNumber of procedures
Pacemaker insertion or repair1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
220099MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Medical Group, Inc Internal Medicine CurrentSince Jul 14, 2008 Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients

Locations

123 Summer St
Ste 290
Worcester, MA 01608
Phone (508) 368-3130

123 Summer St
Ste 290N
Worcester, MA 01608
Phone (508) 368-3130

630 Plantation St
Ste C203
Worcester, MA 01605

630 Plantation St
Fl 2
Worcester, MA 01605

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

Interoperability endpoints

  • Direct secure messaging: douglas.laidlaw.npi1124167911.reliant@direct.optumcare.masshiway.net

Organizations & group practices 2

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 1

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": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716854400000",
    "number": "1124167911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 SUMMER ST STE 290N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081216",
            "telephone_number": "508-368-3130",
            "fax_number": "508-368-3167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 SUMMER ST STE 290N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081216",
            "telephone_number": "508-368-3130",
            "fax_number": "508-368-3167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAIDLAW",
        "first_name": "DOUGLAS",
        "middle_name": "W",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2024-05-28",
        "certification_date": "2024-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Clinical Cardiac Electrophysiology",
            "state": "MA",
            "license": "220099",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": "220099",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.