NPIMap

Organization Active NPI

Quest Diagnostics Massachusetts LLC

  • Clinical Medical Laboratory
  • Cambridge, MA
National Provider Identifier
1477571420
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
22D0989117 Issued in MA
Legal business name
QUEST DIAGNOSTICS MASSACHUSETTS LLC
Practice address
75 Mount Auburn St
Cambridge, MA 02138-4960
Phone
(617) 495-9258
NPI assigned
Jul 18, 2006
Organization subpart
Yes
Parent organization
QUEST DIAGNOSTICS LLC MAAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Authorized official

Name
David Michael Betz
Title
Director
Phone
(412) 920-7774

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 22D0989117 MA Primary

Addresses

Primary practice location

75 Mount Auburn St
Cambridge, MA 02138-4960

Mailing address

14275 Midway Rd Ste 400
Addison, TX 75001-3614
Phone (866) 697-8378

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130627000095 MA Part B Supplier - Independent Clinical Laboratory 8628217486 34 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Holden, MA; Worcester, MA; Westborough, MA; Southborough, MA; Shrewsbury, MA; Milford, MA; Leominster, MA; Hyannis, MA…

Other NPIs on the same Medicare enrollment 33

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 33

National Provider Directory

National Provider Directory
Tax ID family
Quest Diagnostics Massachusetts LLC16 organizations share this tax ID, including this one
Part of
Quest Diagnostics

Other organizations with this tax ID 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1153180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685577600000",
    "number": "1477571420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14275 MIDWAY RD STE 400",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750013614",
            "telephone_number": "866-697-8378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 MOUNT AUBURN ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384960",
            "telephone_number": "617-495-9258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUEST DIAGNOSTICS MASSACHUSETTS LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "QUEST DIAGNOSTICS LLC MA",
        "enumeration_date": "2006-07-18",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "BETZ",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "412-920-7774"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "MA",
            "license": "22D0989117",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; 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.