Active NPI
Merrimack Valley Pet PC
- Radiology Clinic/Center
- Methuen, MA
National Provider Identifier
1407802416
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Radiology Clinic/Center
- License
- 67-0291
- Legal business name
- MERRIMACK VALLEY PET PC
- Practice address
- 70 East St
Methuen, MA 01844-4597 - Phone
- (978) 689-4738
- Fax
- (978) 682-0984
- NPI assigned
- May 25, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Mark R Taylor
- Title
- Ceo
- Phone
- (978) 933-9311
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Radiology Clinic/Center | 261QR0200X | 67-0291 | MA | Primary |
Addresses
Primary practice location
70 East St
Methuen, MA 01844-4597
Mailing address
35 New England Business Center Dr Ste 103
Andover, MA 01810-1080
Phone (978) 933-9311
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2330313 | Other | AETNA HMO | |
| 9723510 | Medicaid | MA | |
| 685730 | Other | TUFTS | |
| 626241 | Other | HARVARD PILGRIM | |
| M17506 | Other | BLUE CROSS OF MA | |
| 0021989 | Other | NEIGHBORHOOD HELATH | |
| 15Y002275MA02 | Other | BLUE CROSS OF NH |
Other names 1
- New England PET Imaging System
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050606000564 | MA | Part B Supplier - Clinic/Group Practice | 7810945888 |
Receives reassigned benefits from 4 practitioners Practice locations: Methuen, MA |
Other NPIs with the same Medicare PAC ID 1
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
National Provider Directory
National Provider Directory- Tax ID family
- Merrimack Valley Pet PC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Mobile Radiology Clinic/Center
- Manchester, NH
- NPI 1922055094
Locations
35 New England Business Center Dr
Ste 103
Andover, MA 01810
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Nuclear Imaging & Therapy Physician
- Burlington, MA
- NPI 1568411320
-
- Diagnostic Radiology Physician
- Methuen, MA
- NPI 1467447730
-
- Diagnostic Radiology Physician
- Lawrence, MA
- NPI 1134193519
-
- Psychiatry Physician
- Sarasota, FL
- NPI 1558421800
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148515200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1736985600000",
"number": "1407802416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 NEW ENGLAND BUSINESS CENTER DR STE 103",
"city": "ANDOVER",
"state": "MA",
"postal_code": "018101080",
"telephone_number": "978-933-9311",
"fax_number": "978-933-7820"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "70 EAST ST",
"city": "METHUEN",
"state": "MA",
"postal_code": "018444597",
"telephone_number": "978-689-4738",
"fax_number": "978-682-0984"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MERRIMACK VALLEY PET PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-25",
"last_updated": "2025-01-16",
"certification_date": "2025-01-16",
"status": "A",
"authorized_official_last_name": "TAYLOR",
"authorized_official_first_name": "MARK",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "978-933-9311",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "261QR0200X",
"taxonomy_group": "",
"desc": "Clinic/Center, Radiology",
"state": "MA",
"license": "67-0291",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "2330313",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9723510",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS",
"identifier": "685730",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "626241",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF MA",
"identifier": "M17506",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBORHOOD HELATH",
"identifier": "0021989",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS OF NH",
"identifier": "15Y002275MA02",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "New England PET Imaging System",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Methuen, MA
- Jessica Mendez, BSN
- Merrimack Dental Assoc., PC
- Merrimack Valley Counseling Center
- Merrimack Valley Medical Associates, PC
- Merrimack Valley Nephrology,Hypertension,& Internal Medicine,PC
- Merrimack Valley Radiation Oncology Associates, LLC
- Merrimack Valley Women'S Health Services
- Ryan James Messier, RN
- Methuen Assisted Living, LP
- Methuen Chiropractic Associates, PLLC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; 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.