NPIMap

Organization Active NPI

Reliant Medical Group, Inc

  • Optometrist
  • Southborough, MA
National Provider Identifier
1437794716
Registry record updated Nov 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
RELIANT MEDICAL GROUP, INC
Practice address
24 Newton St
Southborough, MA 01772-1215
Phone
(508) 460-3150
Fax
(508) 460-3061
NPI assigned
Nov 11, 2019
Last updated
Nov 11, 2019By the provider in NPPES
Organization subpart
Yes
Parent organization
RELIANT MEDICAL GROUP, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 11, 2019

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

Authorized official

Name
Tarek Elsawy
Title
President & Ceo
Phone
(508) 852-0600

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X NU Primary

Addresses

Primary practice location

24 Newton St
Southborough, MA 01772-1215

Mailing address

5 Neponset St
Worcester, MA 01606-2714

National Provider Directory

National Provider Directory
Tax ID family
Fallon Clinic Pharmacy19 organizations share this tax ID, including this one
Part of
Fallon Clinic Pharmacy

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

View all 18

NPI Registry JSON

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

{
    "created_epoch": "1573430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1573430400000",
    "number": "1437794716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 NEPONSET ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062714"
        },
        {
            "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": "508-460-3150",
            "fax_number": "508-460-3061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RELIANT MEDICAL GROUP, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "RELIANT MEDICAL GROUP, INC",
        "enumeration_date": "2019-11-11",
        "last_updated": "2019-11-11",
        "status": "A",
        "authorized_official_last_name": "ELSAWY",
        "authorized_official_first_name": "TAREK",
        "authorized_official_title_or_position": "PRESIDENT & CEO",
        "authorized_official_telephone_number": "508-852-0600"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southborough, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.