Individual provider Active NPI

Michael Roux, M.D.

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1285071142
Registry record updated Sep 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
281142 Issued in MA
Practice address
840 Harrison Ave
Boston, MA 02118
Phone
(617) 638-6610
NPI assigned
May 31, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MT204249 PA
Diagnostic Radiology Physician 2085R0202X 281142 MA Primary

Addresses

Primary practice location

840 Harrison Ave
Boston, MA 02118

Mailing address

720 Harrison Ave # Dob503
Boston, MA 02118-2371
Phone (617) 414-5405

Other practice location 1

1255 S Cedar Crest Blvd Ste 3200
Allentown, PA 18103-6232
Phone (610) 402-1364

Other practice location 2

820 Harrison Ave Bldg 3
Boston, MA 02118-2905
Phone (617) 414-5135

Other practice location 3

820 Harrison Ave Bldg 3
Boston, MA 02118-2905
Phone (617) 414-5135

Other practice location 4

1255 S Cedar Crest Blvd Ste 3200
Allentown, PA 18103-6232
Phone (610) 402-1364

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
I20191002002530 MA Practitioner - Diagnostic Radiology 7315181542 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
New York Medical College, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Merrimack Radiology-Cra LLCGroup PAC ID 8426287269, 60 clinicians
MW Radiology-Cra LLCGroup PAC ID 6406270040, 40 clinicians

Practice addresses (Care Compare)

295 Varnum Ave
Lowell, MA 01854-2134
Phone (978) 937-6240

585 Lebanon St
Melrose, MA 02176-3225
Phone (781) 979-3000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MT204249PAMDInternal Medicine Physician
281142MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Internal Medical Associates-Ebnhc CurrentSince Oct 15, 2019 Accepting new patients
Shields Imaging of Lowell General Hospital LLC CurrentSince Jul 19, 2021 Accepting new patients
Boston University Medical Center Radiologists, Inc. Diagnostic Radiology CurrentSince Oct 15, 2019 Accepting new patients
Shields Imaging of Lowell General Hospital LLC CurrentSince Jul 19, 2021 Accepting new patients
Pratt Radiology Associates, Inc Diagnostic Radiology CurrentSince Jan 19, 2022 Accepting new patients
TMC Radiology Cra LLC Diagnostic Radiology CurrentSince Jul 1, 2022 Accepting new patients
Merrimack Radiology-Cra LLC Diagnostic Radiology CurrentSince Jun 1, 2021 Accepting new patients
Neighborhealth Corporation CurrentSince Oct 15, 2019 Accepting new patients
MW Radiology-Cra LLC Diagnostic Radiology CurrentSince Jul 1, 2022 Accepting new patients
Shields Imaging of Lowell General Hospital LLC CurrentSince Jul 19, 2021 Accepting new patients

Locations

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

102 Endicott St
Danvers, MA 01923
Phone (978) 882-6100

10 Grove St
East Boston, MA 02128
Phone (617) 569-5800

295 Varnum Ave
Lowell, MA 01854
Phone (978) 788-7344

585 Lebanon St
Melrose, MA 02176
Phone (781) 979-3026

720 Harrison Ave
#503
Roxbury, MA 02118
Phone 6174145404 ext. 2

81 Highland Ave
Salem, MA 01970
Phone (978) 354-4009

Organizations & group practices 10

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 2

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": "1369958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568332800000",
    "number": "1285071142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 HARRISON AVE # DOB503",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182371",
            "telephone_number": "617-414-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 HARRISON AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-638-6610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1255 S Cedar Crest Blvd Ste 3200",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "PA",
            "postal_code": "181036232",
            "country_code": "US",
            "telephone_number": "610-402-1364",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "820 Harrison Ave Bldg 3",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021182905",
            "country_code": "US",
            "telephone_number": "617-414-5135",
            "fax_number": "617-638-6616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "820 Harrison Ave Bldg 3",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021182905",
            "country_code": "US",
            "telephone_number": "617-414-5135",
            "fax_number": "617-638-6616",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1255 S Cedar Crest Blvd Ste 3200",
            "address_purpose": "LOCATION",
            "city": "Allentown",
            "state": "PA",
            "postal_code": "181036232",
            "country_code": "US",
            "telephone_number": "610-402-1364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROUX",
        "first_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-31",
        "last_updated": "2019-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MT204249",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "281142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.