Active NPI
George William Poulos, M.D., PH.D.
- Diagnostic Radiology Physician
- Brockton, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 234627
- Practice address
- 680 Centre St
Signature Healthcare, Brockton Hospital, Radiology
Brockton, MA 02302-3308 - Phone
- (508) 941-7150
- NPI assigned
- Mar 31, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 0101278879 | VA | |
| Diagnostic Radiology Physician | 2085R0202X | 234627 | MA | Primary |
Addresses
Primary practice location
680 Centre St
Signature Healthcare, Brockton Hospital, Radiology
Brockton, MA 02302-3308
Mailing address
6 Navaho Dr
Canton, MA 02021-1261
Phone (781) 254-4226
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA, NC
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- Albert Einstein College of Medicine of Yeshiva University, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
130 Quincy Ave
Brockton, MA 02302-2803
Phone (508) 941-7268
166 Quincy Ave
Brockton, MA 02302-2803
Phone (508) 587-5252
176 Quincy Ave
Brockton, MA 02302-2803
Phone (508) 941-7766
178 Quincy Ave
Brockton, MA 02302-2803
Phone (508) 586-7400
680 Centre St
Brockton, MA 02302-3308
Phone (508) 941-7000
Hospital & facility affiliations
- Signature Healthcare Brockton Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.16 of 100
- Quality
- 83.58
- Promoting interoperability
- 94
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 93.55 of 100
- Quality
- 100
- Improvement activities
- 40
- Cost
- 78.49
Merit-based Incentive Payment System (MIPS)
- Final score
- 88.83 of 100
- Quality
- 70.13
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 75.97
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 234627 | MA | MD | Diagnostic Radiology Physician |
| 0101278879 | VA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Signature Healthcare Medical Group Inc | Current | Accepting new patients | |
| Raleigh Radiology, LLC | Diagnostic Radiology | Current | Accepting new patients |
| Raleigh Radiology Associates, Inc. | Diagnostic Radiology | Current | Accepting new patients |
Locations
110 Liberty St
Brockton, MA 02301
680 Centre St
Brockton, MA 02302
Phone (508) 941-7400
150 Parkway Office Ct
Ste 100
Cary, NC 27518
5220 Greens Dairy Rd
Raleigh, NC 27616
Phone (540) 493-4581
3200 Blue Ridge Rd
Ste 100
Raleigh, NC 27612
Phone (919) 256-3576
11640 Northpark Dr
Ste 110
Wake Forest, NC 27587
Interoperability endpoints
- george.poulos@direct.signature.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.
-
- Internal Medicine Physician
- Brockton, MA
- NPI 1508804949
-
- Diagnostic Radiology Physician
- Raleigh, NC
- NPI 1811920101
-
- Diagnostic Radiology Physician
- Raleigh, NC
- NPI 1952527343
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Brockton, MA
- NPI 1063431286
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1206921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690848000000",
"number": "1215109103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6 NAVAHO DR",
"city": "CANTON",
"state": "MA",
"postal_code": "020211261",
"telephone_number": "781-254-4226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "680 CENTRE ST",
"address_2": "SIGNATURE HEALTHCARE, BROCKTON HOSPITAL, RADIOLOGY",
"city": "BROCKTON",
"state": "MA",
"postal_code": "023023308",
"telephone_number": "508-941-7150"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POULOS",
"first_name": "GEORGE",
"middle_name": "WILLIAM",
"credential": "M.D., PH.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-03-31",
"last_updated": "2023-08-01",
"certification_date": "2023-08-01",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "VA",
"license": "0101278879",
"primary": false
},
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "MA",
"license": "234627",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Brockton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.