NPIMap

Organization Active NPI

Medical Associates Pediatrics, P.C.

  • Pediatric Adolescent Medicine Physician
  • Leominster, MA
National Provider Identifier
1417946161
Registry record updated Jun 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Adolescent Medicine PhysicianTaxonomy code 2080A0000X
Legal business name
MEDICAL ASSOCIATES PEDIATRICS, P.C.
Practice address
100 Hospital Rd
Suite 4
Leominster, MA 01453-2253
Phone
(978) 514-6300
Fax
(978) 514-6321
NPI assigned
Oct 17, 2005
Last updated
Jun 24, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2011

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

Authorized official

Name
Neil Ohear
Title
Adminsitrator
Phone
(978) 514-6300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X MA Primary

Addresses

Primary practice location

100 Hospital Rd
Suite 4
Leominster, MA 01453-2253

Mailing address

100 Hospital Rd
Suite 4
Leominster, MA 01453-2253
Phone (978) 514-6300

Other identifiers 1

IdentifierTypeStateIssuer
9782958MedicaidMA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050531000480 MA Part B Supplier - Clinic/Group Practice 6709828718 Receives reassigned benefits from 7 practitioners
Practice locations: Leominster, MA

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D0068852Medical Associates Pediatrics PC100 Hospital Rd Ste 4a, Leominster, MA 01453ComplianceOct 20, 2027

National Provider Directory

National Provider Directory

Locations

100 Hospital Rd
Ste 4
Leominster, MA 01453
Phone (978) 514-6300

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308873600000",
    "number": "1417946161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL RD",
            "address_2": "SUITE 4",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014532253",
            "telephone_number": "978-514-6300",
            "fax_number": "978-514-6321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HOSPITAL RD",
            "address_2": "SUITE 4",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014532253",
            "telephone_number": "978-514-6300",
            "fax_number": "978-514-6321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ASSOCIATES PEDIATRICS, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-17",
        "last_updated": "2011-06-24",
        "status": "A",
        "authorized_official_last_name": "OHEAR",
        "authorized_official_first_name": "NEIL",
        "authorized_official_title_or_position": "ADMINSITRATOR",
        "authorized_official_telephone_number": "978-514-6300"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9782958",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leominster, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (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.