NPIMap

Organization Active NPI

New England Molecular Imaging, LLC

  • Radiology Clinic/Center
  • Derry, NH
National Provider Identifier
1275569782
Registry record updated Oct 31, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
01601 Issued in NH
Legal business name
NEW ENGLAND MOLECULAR IMAGING, LLC
Practice address
6 Tsienneto Rd
Derry, NH 03038
Phone
(603) 537-1380
NPI assigned
Jun 25, 2006
Last updated
Oct 31, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2022

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

Authorized official

Name
Laura Kassa
Title
Sr VP
Phone
(904) 300-2777

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X 01601 NH Primary
Mobile Radiology Clinic/Center 261QR0208X

Addresses

Primary practice location

6 Tsienneto Rd
Derry, NH 03038

Mailing address

18201 Von Karman Ave Ste 600
Irvine, CA 92612-1176
Phone (800) 544-3215

Other practice location 1

15 Tsienneto Rd
Derry, NH 03038-1557
Phone (603) 537-1380

Other practice location 2

14A Tsienneto Rd
Derry, NH 03038-1505
Phone (603) 537-1380

Other identifiers 4

IdentifierTypeStateIssuer
3962939OtherNHAETNA
694993OtherNHTUFTS/SECURE HORIZONS
800942OtherNHHARVARD PILGRIM HLTH CARE
P00302999OtherNHRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041230000480 NH Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 1850378969 Practice locations: Derry, NH

Other NPIs with the same Medicare PAC ID 7

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
New England Molecular Imaging LLC9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

6 Tsienneto Rd
Londonderry, NH 03038
Phone (603) 421-9959

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667174400000",
    "number": "1275569782",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18201 VON KARMAN AVE STE 600",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926121176",
            "telephone_number": "800-544-3215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 TSIENNETO RD",
            "city": "DERRY",
            "state": "NH",
            "postal_code": "03038",
            "telephone_number": "603-537-1380"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15 Tsienneto Rd",
            "address_purpose": "LOCATION",
            "city": "Derry",
            "state": "NH",
            "postal_code": "030381557",
            "country_code": "US",
            "telephone_number": "603-537-1380",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14A Tsienneto Rd",
            "address_purpose": "LOCATION",
            "city": "Derry",
            "state": "NH",
            "postal_code": "030381505",
            "country_code": "US",
            "telephone_number": "603-537-1380",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NEW ENGLAND MOLECULAR IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-25",
        "last_updated": "2022-10-31",
        "certification_date": "2022-10-31",
        "status": "A",
        "authorized_official_last_name": "KASSA",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "SR VP",
        "authorized_official_telephone_number": "904-300-2777"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "NH",
            "license": "01601",
            "primary": true
        },
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3962939",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS/SECURE HORIZONS",
            "identifier": "694993",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HLTH CARE",
            "identifier": "800942",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00302999",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Derry, NH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.