NPIMap

Individual provider Active NPI

Gregory N. Emmanuel, M.D.

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1164764791
Registry record updated Apr 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
278020 Issued in MA
Practice address
55 Fruit St
Boston, MA 02114-2621
Phone
(617) 724-9729
NPI assigned
Mar 21, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 278020 MA Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2621

Mailing address

800 Washington Street
Department of Radiology
Boston, MA 02111-4431

Other practice location 1

41 Mall Rd
Burlington, MA 01805-2621
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
I20190613002455 MA Practitioner - Diagnostic Radiology 5496090003 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Albany Medical College of Union University, 2013
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)

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

16 Hayden Ave
Lexington, MA 02421-7929
Phone (781) 372-7100

29 Mall Rd
Burlington, MA 01805-0001

41 Mall Rd
Burlington, MA 01805-0001

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
278020MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
TMC Radiology Cra LLC Diagnostic Radiology CurrentSince Jul 1, 2022 Accepting new patients
Lahey Clinic, Inc CurrentSince Apr 19, 2022 Accepting new patients
Boston Medical Imaging Associates Diagnostic Radiology Current Accepting new patients
Lahey Clinic, Inc. CurrentSince Apr 19, 2022 Accepting new patients
Mass General Brigham Medical Group Western Massachusetts Inc CurrentSince Jul 1, 2020 Accepting new patients

Locations

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

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

67 Union St
Ste 309
Natick, MA 01760
Phone (508) 383-4576

67 Union St
Ofc
Natick, MA 01760
Phone (508) 333-7333

30 Locust St
Northampton, MA 01060
Phone (413) 582-2000

Interoperability endpoints

  • Direct secure messaging: gemmanuel179966@direct.bilh.masshiway.net

Organizations & group practices 6

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": "1363824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650326400000",
    "number": "1164764791",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON STREET",
            "address_2": "DEPARTMENT OF RADIOLOGY",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021114431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-724-9729"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "41 Mall Rd",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "MA",
            "postal_code": "018052621",
            "country_code": "US",
            "telephone_number": "781-744-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EMMANUEL",
        "first_name": "GREGORY",
        "middle_name": "N.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-21",
        "last_updated": "2022-04-19",
        "certification_date": "2022-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "278020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.