NPIMap

Organization Active NPI

Saint Vincent Radiological Associates Inc

  • Diagnostic Radiology Physician
  • Worcester, MA
National Provider Identifier
1366482093
Registry record updated Feb 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
SAINT VINCENT RADIOLOGICAL ASSOCIATES INC
Practice address
123 Summer St
Worcester, MA 01608-1216
Phone
(508) 363-5000
Fax
(978) 939-2039
NPI assigned
Jun 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2024

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

Authorized official

Name
David A BaderNPI 1154376143
Title
President
Phone
(978) 939-2035

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X MA
Nuclear Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207U00000X MA
Neuroradiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085N0700X MA
Diagnostic Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0202X MA Primary
Vascular & Interventional Radiology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2085R0204X MA

Addresses

Primary practice location

123 Summer St
Worcester, MA 01608-1216

Mailing address

PO Box 824
Indianapolis, IN 46206-0824
Phone (978) 939-2035

Other identifiers 8

IdentifierTypeStateIssuer
9703284OtherMAHEALTHY START
49925OtherMAFALLON ATHOL
600428OtherMAHARVARD PILGRIM HEALTH PL
6070OtherMAFALLON COMMUNITY HEALTH P
800185OtherMATUFTS HEALTH PLAN
9703284MedicaidMA
62965OtherMAAETNA
CK1296OtherMARAILROAD MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, TX, IL3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
O20040819001249 MA Part B Supplier - Clinic/Group Practice 1850365578 Receives reassigned benefits from 29 practitioners
Practice locations: North Andover, MA; Worcester, MA; Winthrop, MA; Templeton, MA; Somerville, MA; Lynn, MA; Auburn, MA; Auburndale, MA…
O20240215000530 TX Part B Supplier - Clinic/Group Practice 1850365578 Receives reassigned benefits from 3 practitioners
Practice locations: Dallas, TX; Houston, TX; New Braunfels, TX
O20240315002325 IL Part B Supplier - Clinic/Group Practice 1850365578 Receives reassigned benefits from 1 practitioner
Practice locations: Glenview, IL

National Provider Directory

National Provider Directory

Locations

61 Lincoln St
Ste 10
Framingham, MA 01702

100 Grove St
Worcester, MA 01605
Phone (508) 752-3763

1 Eaton Pl
Ste 22
Worcester, MA 01608
Phone (508) 363-6881

Practitioners & affiliated clinicians

Practitioners 60

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 60

NPI Registry JSON

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

{
    "created_epoch": "1149724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706832000000",
    "number": "1366482093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 824",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462060824",
            "telephone_number": "978-939-2035",
            "fax_number": "978-939-2039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 SUMMER ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081216",
            "telephone_number": "508-363-5000",
            "fax_number": "978-939-2039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAINT VINCENT RADIOLOGICAL ASSOCIATES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-08",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A",
        "authorized_official_last_name": "BADER",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-939-2035"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nuclear Medicine",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Neuroradiology",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "MA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHY START",
            "identifier": "9703284",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON ATHOL",
            "identifier": "49925",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM HEALTH PL",
            "identifier": "600428",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON COMMUNITY HEALTH P",
            "identifier": "6070",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "800185",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9703284",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "62965",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CK1296",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; 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.