Individual provider Active NPI

Thomas Ptak, MD PHD

  • Diagnostic Radiology Physician
  • Worcester, MA
National Provider Identifier
1467436394
Registry record updated May 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
MD487489 Issued in PA
Practice address
55 Lake Ave N
Worcester, MA 01655-0002
Phone
(508) 334-3850
NPI assigned
Dec 5, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 74590 MA
Diagnostic Radiology Physician 2085R0202X MD487489 PA Primary
Diagnostic Radiology Physician 2085R0202X D0083946 MD
Neuroradiology Physician 2085N0700X D0083946 MD

Addresses

Primary practice location

55 Lake Ave N
Worcester, MA 01655-0002

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885

Other practice location 1

252 S 4th St
Lebanon, PA 17042-6111
Phone (717) 270-7732

Other practice location 2

35 Erick Rd
Lancaster, PA 17601-3111
Phone (717) 690-0785

Other practice location 3

460 N Reading Rd
Ephrata, PA 17522-9606
Phone (717) 721-4840

Other practice location 4

36 Robinhood Dr
Etters, PA 17319-9528
Phone (717) 388-7300

Other practice location 5

1201 Letort Springs Way
Carlisle, PA 17015-8011
Phone (717) 674-7600

Other practice location 6

35 Monument Rd Ste 201
York, PA 17403-5074
Phone (717) 812-4083

Other practice location 7

22 S Greene St Rm S2A19
Baltimore, MD 21201-1544
Phone (410) 328-3477

Other practice location 8

169 Martin Ave
Ephrata, PA 17522-1734
Phone (717) 738-6414

Other practice location 9

112 N 7th St
Chambersburg, PA 17201-1720
Phone (717) 262-4499

Other practice location 10

14781 Wolfe Rd
New Freedom, PA 17349-9571
Phone (717) 326-1880

Other practice location 11

147 Gettys St
Gettysburg, PA 17325-2534
Phone (717) 337-4207

Other identifiers 2

IdentifierTypeStateIssuer
889007200MedicaidMD
091658433MedicaidDC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, MD, DC, PA4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20040203000533 MA Practitioner - Diagnostic Radiology 9537052766 Reassigns benefits to 2 organizations
I20171116001033 MD Practitioner - Diagnostic Radiology 9537052766 Reassigns benefits to 6 organizations
I20181207001757 DC Practitioner - Diagnostic Radiology 9537052766 Reassigns benefits to 1 organization
I20251015004839 PA Practitioner - Diagnostic Radiology 9537052766 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians
Medical Imaging of Lehigh Valley PCGroup PAC ID 1557265212, 115 clinicians
Wellspan Medical GroupGroup PAC ID 1951213115, 2,438 clinicians

Practice addresses (Care Compare)

Severn, MD 21144
Phone (508) 334-3850

1524 Willow Branch Way
Severn, MD 21144-6829
Phone (610) 770-1606

169 Martin Ave
Ephrata, PA 17522-1724
Phone (717) 738-6414

22 S Green St
Baltimore, MD 21201-1544
Phone (410) 328-5700

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0083946MDMDNeuroradiology Physician
74590MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group Inc CurrentSince May 1, 2024 Accepting new patients
Wellspan Medical Group CurrentSince Jan 19, 2026 Accepting new patients
Lehigh Valley Physician Group Current Accepting new patients
Lehigh Valley Physician Group CurrentSince Oct 2, 2025 Accepting new patients
University of Maryland Diagnostic Radiology, LLC Neuroradiology CurrentSince Nov 26, 2017 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince May 1, 2024 Accepting new patients
Wellspan Medical Group Diagnostic Radiology CurrentSince Jan 19, 2026 Accepting new patients
Lehigh Valley Physician Group CurrentSince Oct 2, 2025 Accepting new patients
University of Maryland Diagnostic Imaging Specialists P a Neuroradiology CurrentSince Oct 16, 2017 Accepting new patients
University of Maryland Diagnostic Imaging Specialists P a Neuroradiology CurrentSince Oct 16, 2017 Accepting new patients
Medical Imaging of Lehigh Valley PC Diagnostic Radiology CurrentSince Jan 1, 2025 Accepting new patients
University of Maryland Diagnostic Radiology, LLC Neuroradiology CurrentSince Nov 26, 2017 Accepting new patients
University Imaging Center, LLC Neuroradiology CurrentSince Oct 16, 2017 Accepting new patients
University Imaging Center, LLC Neuroradiology CurrentSince Oct 16, 2017 Accepting new patients
Umass Memorial MRI - Marlborough CurrentSince Apr 1, 2025 Accepting new patients
Lehigh Valley Diagnostic Imaging Past Accepting new patients
Boston University Medical Center Radiologists, Inc. Neuroradiology Past Accepting new patients
Columbus Radiology Corp Diagnostic Radiology Past Accepting new patients
University of Maryland Diagnostic Imaging Specialists P a Neuroradiology PastSince Jan 26, 2025 Accepting new patients
Scranton Hospitalist Physician Services LLC Diagnostic Radiology PastSince May 7, 2025 Accepting new patients

Locations (25 of 97)

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

14 Prospect St
Milford, MA 01757
Phone (508) 422-2343

340 Thompson Rd
Webster, MA 01570
Phone (508) 943-2600

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

22 S Greene St
Rm N2E23
Baltimore, MD 21201
Phone (410) 328-5656

22 S Greene St
Rm S2A19
Baltimore, MD 21201
Phone (410) 328-1565

419 W Redwood St
Baltimore, MD 21201
Phone (410) 328-5196

827 Linden Ave
Baltimore, MD 21201
Phone (410) 225-8100

15001 Health Center Dr
Bowie, MD 20716
Phone (301) 262-5511

1717 N Market St
Apt 202
Frederick, MD 21701

5 Garrett Ave
La Plata, MD 20646
Phone (301) 609-4000

5 N La Plata Ct
Ste 104
La Plata, MD 20646
Phone (301) 539-0345

7300 Van Dusen Rd
Laurel, MD 20707
Phone (301) 725-4300

2200 Kernan Dr
Woodlawn, MD 21207
Phone (410) 448-2500

1621 N Cedar Crest Blvd
Allentown, PA 18104
Phone (610) 402-3300

1220 S Cedar Crest Blvd
Allentown, PA 18103
Phone (610) 740-0400

1230 S Cedar Crest Blvd
Ste 103
Allentown, PA 18103
Phone (610) 402-4691

1243 S Cedar Crest Blvd
Allentown, PA 18103
Phone (610) 402-9230

1240 S Cedar Crest Blvd
Ste 203
Allentown, PA 18103
Phone (610) 402-0690

1503 N Cedar Crest Blvd
Allentown, PA 18104
Phone (610) 871-9110

798 Hausman Rd
Allentown, PA 18104
Phone (610) 530-1515

1791 Airport Rd
Allentown, PA 18109
Phone (484) 240-8195

1250 S Cedar Crest Blvd
Ste 110
Allentown, PA 18103
Phone (610) 435-1003

1200 S Cedar Crest Blvd
Allentown, PA 18103
Phone (484) 862-3200

Organizations & group practices 22

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.

View all 22

Hospital & facility affiliations 12

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": "1133740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779321600000",
    "number": "1467436394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885",
            "fax_number": "508-334-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-334-3850"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "252 S 4th St",
            "address_purpose": "LOCATION",
            "city": "Lebanon",
            "state": "PA",
            "postal_code": "170426111",
            "country_code": "US",
            "telephone_number": "717-270-7732",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "35 Erick Rd",
            "address_purpose": "LOCATION",
            "city": "Lancaster",
            "state": "PA",
            "postal_code": "176013111",
            "country_code": "US",
            "telephone_number": "717-690-0785",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "460 N Reading Rd",
            "address_purpose": "LOCATION",
            "city": "Ephrata",
            "state": "PA",
            "postal_code": "175229606",
            "country_code": "US",
            "telephone_number": "717-721-4840",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "36 Robinhood Dr",
            "address_purpose": "LOCATION",
            "city": "Etters",
            "state": "PA",
            "postal_code": "173199528",
            "country_code": "US",
            "telephone_number": "717-388-7300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1201 Letort Springs Way",
            "address_purpose": "LOCATION",
            "city": "Carlisle",
            "state": "PA",
            "postal_code": "170158011",
            "country_code": "US",
            "telephone_number": "717-674-7600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "35 Monument Rd Ste 201",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174035074",
            "country_code": "US",
            "telephone_number": "717-812-4083",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "22 S Greene St Rm S2A19",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212011544",
            "country_code": "US",
            "telephone_number": "410-328-3477",
            "fax_number": "410-328-1190",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "169 Martin Ave",
            "address_purpose": "LOCATION",
            "city": "Ephrata",
            "state": "PA",
            "postal_code": "175221734",
            "country_code": "US",
            "telephone_number": "717-738-6414",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "112 N 7th St",
            "address_purpose": "LOCATION",
            "city": "Chambersburg",
            "state": "PA",
            "postal_code": "172011720",
            "country_code": "US",
            "telephone_number": "717-262-4499",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "14781 Wolfe Rd",
            "address_purpose": "LOCATION",
            "city": "New Freedom",
            "state": "PA",
            "postal_code": "173499571",
            "country_code": "US",
            "telephone_number": "717-326-1880",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "147 Gettys St",
            "address_purpose": "LOCATION",
            "city": "Gettysburg",
            "state": "PA",
            "postal_code": "173252534",
            "country_code": "US",
            "telephone_number": "717-337-4207",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PTAK",
        "first_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-05",
        "last_updated": "2026-05-21",
        "certification_date": "2026-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "74590",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "PA",
            "license": "MD487489",
            "primary": true
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D0083946",
            "primary": false
        },
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "MD",
            "license": "D0083946",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "889007200",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "091658433",
            "state": "DC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.