NPIMap

Organization Active NPI

Greater Lowell Pet PC

  • Radiology Clinic/Center
  • Lowell, MA
National Provider Identifier
1407802804
Registry record updated Jan 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology Clinic/CenterTaxonomy code 261QR0200X
License
67-0397 Issued in MA
Legal business name
GREATER LOWELL PET PC
Practice address
2 Hospital Dr
Lowell, MA 01852-1311
Phone
(978) 458-9872
Fax
(978) 458-9876
NPI assigned
May 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2025

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

Authorized official

Name
Mark R Taylor
Title
Ceo
Phone
(978) 933-9311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Clinic/Center 261QR0200X 67-0397 MA Primary

Addresses

Primary practice location

2 Hospital Dr
Lowell, MA 01852-1311

Mailing address

35 New England Business Center Dr Ste 103
Andover, MA 01810-1080
Phone (978) 933-9302

Other identifiers 6

IdentifierTypeStateIssuer
699024OtherTUFTS
9726730MedicaidMA
0029226OtherNEIGHBORHOOD HEALTH
3184313OtherAETNA
626417OtherHARVARD PILGRIM
M18082OtherBLUE CROSS OF MA

Other names 1

  • New England PET of Greater Lowell Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041220000019 MA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 4688631880 Practice locations: Lowell, MA

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

354 Merrimack St
#D
Lawrence, MA 01843

295 Varnum Ave
Ste 200
Lowell, MA 01854

2 Hospital Dr
Lowell, MA 01852
Phone (978) 458-9872

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1407802804",
    "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": "978-933-9302",
            "fax_number": "789-337-8209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 HOSPITAL DR",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018521311",
            "telephone_number": "978-458-9872",
            "fax_number": "978-458-9876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER LOWELL PET PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "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"
    },
    "taxonomies": [
        {
            "code": "261QR0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology",
            "state": "MA",
            "license": "67-0397",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "699024",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9726730",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH",
            "identifier": "0029226",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3184313",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "626417",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF MA",
            "identifier": "M18082",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "New England PET of Greater Lowell",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lowell, MA

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.

Verify at the official NPI Registry.