Individual provider Active NPI

Sean P Reid, MD

  • Emergency Medicine Physician
  • Worcester, MA
National Provider Identifier
1386201911
Registry record updated Feb 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
1013272 Issued in MA
Practice address
55 Lake Ave N
Worcester, MA 01655-0002
Phone
(508) 421-1401
Fax
(508) 421-1490
NPI assigned
May 20, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 1013272 MA Primary

Addresses

Primary practice location

55 Lake Ave N
Worcester, MA 01655-0002

Mailing address

PO Box 415348
Boston, MA 02241-5348

Other practice location 1

242 Green St
Gardner, MA 01440-1373
Phone (978) 632-3420

Other identifiers 1

IdentifierTypeStateIssuer
110194773AMedicaidMA

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
I20240326003724 MA Practitioner - Emergency Medicine 9931432168 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Henry Heywood Memorial HospitalGroup PAC ID 1658262605, 116 clinicians
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

242 Green St
Gardner, MA 01440-1336
Phone (978) 632-3420

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1013272MAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Athol Memorial Hospital Incorporated Emergency Medicine CurrentSince Mar 14, 2024 Accepting new patients
Henry Heywood Memorial Hospital Emergency Medicine CurrentSince Mar 14, 2024 Accepting new patients
Henry Heywood Memorial Hospital CurrentSince Mar 14, 2024 Accepting new patients
Umass Memorial Medical Group Inc Emergency Medicine CurrentSince Feb 4, 2025 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Feb 4, 2025 Accepting new patients

Locations

2033 Main St
Athol, MA 01331
Phone (978) 249-1295

242 Green St
Gardner, MA 01440
Phone (978) 258-4734

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

593 Eddy St
Providence, RI 02903

Organizations & group practices 5

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 3

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": "1558310400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738627200000",
    "number": "1386201911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-421-1401",
            "fax_number": "508-421-1490"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "242 Green St",
            "address_purpose": "LOCATION",
            "city": "Gardner",
            "state": "MA",
            "postal_code": "014401373",
            "country_code": "US",
            "telephone_number": "978-632-3420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REID",
        "first_name": "SEAN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-20",
        "last_updated": "2025-02-04",
        "certification_date": "2025-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "1013272",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110194773A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.