NPIMap

Individual provider Active NPI

Peter Marcinkowski

  • Surgical Critical Care Physician
  • Burlington, MA
National Provider Identifier
1134574734
Registry record updated Jan 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Critical Care PhysicianTaxonomy code 2086S0102X
License
218423 Issued in MA
Practice address
41 Mall Rd
Burlington, MA 01805-7050
Phone
(781) 744-8000
NPI assigned
May 2, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 294418 MA
Surgery Physician 208600000X 218423 NC
Surgical Critical Care Physician 2086S0102X 218423 MA Primary

Addresses

Primary practice location

41 Mall Rd
Burlington, MA 01805-7050

Mailing address

4001 Burnett Womack Building
CB #7050
Chapel Hill, NC 27599-7050

Other practice location 1

4001 Burnett Womack Building
CB #7050
Chapel Hill, NC 27599-7050
Phone (919) 966-4320

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
I20220928003791 MA Practitioner - General Surgery 9739478280 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of North Carolina at Chapel Hill School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lahey Clinic IncGroup PAC ID 2264336528, shared by 3 NPIs, 1,381 clinicians

Practice addresses (Care Compare)

41 Mall Rd
Burlington, MA 01805-0001

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Hernia repair - groin (open)1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
294418MAMDSurgery Physician
218423NCMDSurgery Physician
218423MAMDSurgical Critical Care Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lahey Clinic, Inc. CurrentSince Sep 1, 2022 Accepting new patients
Lahey Clinic, Inc Current Accepting new patients
Lahey Clinic Hospital, Inc. Past Accepting new patients

Locations

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

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

Interoperability endpoints

  • Direct secure messaging: pmarcinkowski185497@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 5

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": "1462147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674604800000",
    "number": "1134574734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 BURNETT WOMACK BUILDING",
            "address_2": "CB #7050",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275997050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 MALL RD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018057050",
            "telephone_number": "781-744-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4001 Burnett Womack Building",
            "address_2": "CB #7050",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275997050",
            "country_code": "US",
            "telephone_number": "919-966-4320",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARCINKOWSKI",
        "first_name": "PETER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-05-02",
        "last_updated": "2023-01-25",
        "certification_date": "2023-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "294418",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NC",
            "license": "218423",
            "primary": false
        },
        {
            "code": "2086S0102X",
            "taxonomy_group": "",
            "desc": "Surgery, Surgical Critical Care",
            "state": "MA",
            "license": "218423",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

Verify at the official NPI Registry.