NPIMap

Organization Active NPI

Lianne Inc

  • Family Medicine Physician
  • Worcester, MA
National Provider Identifier
1457773541
Registry record updated Nov 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
229350 Issued in MA
Legal business name
LIANNE INC
Practice address
200 Lincoln St
Worcester, MA 01605-2528
Phone
(508) 755-1222
Fax
(855) 999-9140
NPI assigned
Jan 9, 2014
Last updated
Nov 6, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
LIANNE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 6, 2015

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

Authorized official

Name
Mohammad Alhabbal, MDNPI 1366469728
Title
Vice President
Phone
(508) 414-0200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 229350 MA Primary

Addresses

Primary practice location

200 Lincoln St
Worcester, MA 01605-2528

Mailing address

21 Colonial Dr
Shrewsbury, MA 01545-1522
Phone (508) 755-1222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140711000113 MA Part B Supplier - Clinic/Group Practice 4587889365 Receives reassigned benefits from 29 practitioners
Practice locations: Worcester, MA

National Provider Directory

National Provider Directory
Part of
Lianne Inc

Practitioners & affiliated clinicians

Practitioners 29

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 29

NPI Registry JSON

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

{
    "created_epoch": "1389225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446768000000",
    "number": "1457773541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 COLONIAL DR",
            "city": "SHREWSBURY",
            "state": "MA",
            "postal_code": "015451522",
            "telephone_number": "508-755-1222",
            "fax_number": "855-999-9140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 LINCOLN ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016052528",
            "telephone_number": "508-755-1222",
            "fax_number": "855-999-9140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIANNE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIANNE INC",
        "enumeration_date": "2014-01-09",
        "last_updated": "2015-11-06",
        "status": "A",
        "authorized_official_last_name": "ALHABBAL",
        "authorized_official_first_name": "MOHAMMAD",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "508-414-0200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "229350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2015; 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.