Beacon Pathology LLC – Clinical Medical Laboratory

Key facts

NPI: 1376914531
Entity type: Organization (NPI type 2)
Primary specialty: Clinical Medical Laboratory 291U00000X
Legal business name: BEACON PATHOLOGY LLC
Practice address: 35 Brookfield Rd
Dover, MA 02030-1805
Phone: (617) 314-5976
NPI assigned: Oct 14, 2015
Organization subpart: No

Authorized official

Name: Alireza Sepehr, MD NPI 1336171867
Title: MD, Owner
Phone: (617) 314-5976

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

Practitioners 1

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

Alireza Sepehr, M.D. Anatomic Pathology & Clinical Pathology Physician · Dover, MA · NPI 1336171867

Medicare reassignment NPD Authorized official MA

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA number	Laboratory	Certificate	Expires
22D2063384	Beacon Pathology LLC 35 Brookfield Road, Dover, MA 02030	Compliance	May 19, 2028

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MA

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20151222001020	MA	Part B Supplier - Clinic/Group Practice	7517268253	Receives reassigned benefits from 1 practitioner Practice locations: Dover, MA

National Provider Directory

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Clinical Medical Laboratory	291U00000X			Yes

Addresses

Primary practice location

35 Brookfield Rd
Dover, MA 02030-1805

Mailing address

35 Brookfield Rd
Dover, MA 02030-1805
Phone (617) 314-5976

Other providers in Dover, MA

All providers in Dover, MA · Clinical Medical Laboratory in Massachusetts

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 14, 2015. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.