Individual provider Active NPI

John W Trudel, MD

  • Family Medicine Physician
  • Westborough, MA
National Provider Identifier
1265493738
Registry record updated Apr 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
77116 Issued in MA
Practice address
900 Union St
Westborough, MA 01581-5408
Phone
(508) 871-0700
Fax
(508) 616-4411
NPI assigned
Mar 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 77116 MA Primary

Addresses

Primary practice location

900 Union St
Westborough, MA 01581-5408

Mailing address

900 Union St
Westborough, MA 01581-5408
Phone (508) 871-0700

Other identifiers 18

IdentifierTypeStateIssuer
042472266OtherONE HEALTH PLAN
91114OtherFALLON COMMUNITY HEALTH P
AA1187OtherHARVARD PILGRIM HEALTHCAR
J14750OtherMEDICARE B
27004OtherHEALTHY START
0100296OtherEVERCARE
042472266OtherHEALTHCARE VALUE MANAGEME
042472266OtherPRIVATE HEALTHCARE SYSTEM
27004OtherCHILDRENS MEDICAL SECURIT
4666601OtherCIGNA HEALTH PLAN
J14750OtherBLUE SHIELD HMO BLUE
5565516OtherAETNA US HEALTHCARE
784204OtherMVP HEALTH CARE
934715OtherFIRST HEALTH
3130720OtherMEDICAID WELFARE
J14750OtherBLUE SHIELD INDEMNITY
3130720MedicaidMA
J14750OtherBLUE CARE ELECT

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
I20050513000702 MA Practitioner - Family Practice 3870534449 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Albany Medical College of Union University, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

900 Union St
Westborough, MA 01581-5408
Phone (508) 366-8836

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Reliant Medical Group, Inc Family Medicine CurrentSince Sep 16, 1994 Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients

Locations

900 Union St
Westborough, MA 01581
Phone (508) 871-0700

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

630 Plantation St
Worcester, MA 01605
Phone (508) 368-5529

630 Plantation St
#12
Worcester, MA 01605

Interoperability endpoints

  • Direct secure messaging: john.trudel.npi1265493738.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.

NPI Registry JSON

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

{
    "created_epoch": "1143763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522627200000",
    "number": "1265493738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 UNION ST",
            "city": "WESTBOROUGH",
            "state": "MA",
            "postal_code": "015815408",
            "telephone_number": "508-871-0700",
            "fax_number": "508-616-4411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 UNION ST",
            "city": "WESTBOROUGH",
            "state": "MA",
            "postal_code": "015815408",
            "telephone_number": "508-871-0700",
            "fax_number": "508-616-4411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRUDEL",
        "first_name": "JOHN",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-31",
        "last_updated": "2018-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "77116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ONE HEALTH PLAN",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON COMMUNITY HEALTH P",
            "identifier": "91114",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTHCAR",
            "identifier": "AA1187",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE B",
            "identifier": "J14750",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHY START",
            "identifier": "27004",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EVERCARE",
            "identifier": "0100296",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHCARE VALUE MANAGEME",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE HEALTHCARE SYSTEM",
            "identifier": "042472266",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHILDRENS MEDICAL SECURIT",
            "identifier": "27004",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA HEALTH PLAN",
            "identifier": "4666601",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD HMO BLUE",
            "identifier": "J14750",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA US HEALTHCARE",
            "identifier": "5565516",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MVP HEALTH CARE",
            "identifier": "784204",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "934715",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID WELFARE",
            "identifier": "3130720",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD INDEMNITY",
            "identifier": "J14750",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3130720",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE ELECT",
            "identifier": "J14750",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Westborough, MA

Sources for this page

Verify at the official NPI Registry.