Individual provider Active NPI

Diane Lockhart, MD

  • Surgery Physician
  • Southborough, MA
National Provider Identifier
1407917412
Registry record updated Mar 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
151434 Issued in MA
Practice address
24 Newton St
Southborough, MA 01772-1215
Phone
(508) 486-4472
Fax
(508) 486-4474
NPI assigned
Dec 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 151434 MA Primary

Addresses

Primary practice location

24 Newton St
Southborough, MA 01772-1215

Mailing address

24 Newton St
Southborough, MA 01772-1215
Phone (508) 486-4472

Other identifiers 6

IdentifierTypeStateIssuer
0021544OtherMANHP
792099OtherMATUFTS
1226445-004OtherMACIGNA
J17041OtherMABCBS
S2OtherMAHPHC
3191800MedicaidMA

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
I20100113000707 MA Practitioner - General Surgery 9739220633 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
University of Massachusetts Medical School, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

24 Newton St
Southborough, MA 01772-1215
Phone (508) 486-4472

Hospital & facility affiliations

  • St Vincent Hospital Hospital, Worcester, MA, CCN 220176

Procedures performed for Medicare patients

ProcedureNumber of procedures
Mastectomy1-10
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Vincent Physician Services, Inc. Surgery CurrentSince May 20, 2013 Accepting new patients
Reliant Medical Group, Inc CurrentSince Jan 17, 2023 Accepting new patients
Saint Vincent Radiological Associates Inc Past Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients

Locations

24 Newton St
Southborough, MA 01772
Phone (508) 460-3190

123 Summer St
#273
Worcester, MA 01608
Phone (508) 363-6327

123 Summer St
Worcester, MA 01608
Phone (508) 363-6000

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

5 Neponset St
#12
Worcester, MA 01606
Phone (508) 595-2300

123 Summer St
Ste 210
Worcester, MA 01608
Phone (508) 368-3190

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

Interoperability endpoints

  • Direct secure messaging: diane.lockhart.npi1407917412.reliant@direct.optumcare.masshiway.net

Organizations & group practices 4

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 1

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": "1165968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743120000000",
    "number": "1407917412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 NEWTON ST",
            "city": "SOUTHBOROUGH",
            "state": "MA",
            "postal_code": "017721215",
            "telephone_number": "508-486-4472",
            "fax_number": "508-486-4474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 NEWTON ST",
            "city": "SOUTHBOROUGH",
            "state": "MA",
            "postal_code": "017721215",
            "telephone_number": "508-486-4472",
            "fax_number": "508-486-4474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOCKHART",
        "first_name": "DIANE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-13",
        "last_updated": "2025-03-28",
        "certification_date": "2025-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "151434",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHP",
            "identifier": "0021544",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "792099",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1226445-004",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "J17041",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "S2",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3191800",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Southborough, MA

Sources for this page

Verify at the official NPI Registry.