Wachusett Radiology, Inc.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

Legal business name

WACHUSETT RADIOLOGY, INC.

Practice address

242 Green St
Radiology Department
Gardner, MA 01440-1336

Phone

(997) 863-0623

Fax

(978) 630-6353

NPI assigned

Jul 6, 2006

Organization subpart

No

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

Authorized official

Name

Laura Chen, MD

Title

President

Phone

(978) 632-7383

Specialties & licenses 3

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Farid Abdulrehman Thanawalla, M.D.

  • Vascular & Interventional Radiology Physician
  • Goodlettsville, TN
  • NPI 1770558496

  Diagnostic Radiology

  NPD (past)

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1528090131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 LITTLE BROOK RD",
            "city": "WEST WAREHAM",
            "state": "MA",
            "postal_code": "025761222",
            "telephone_number": "800-841-5200",
            "fax_number": "508-273-1241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 GREEN ST",
            "address_2": "RADIOLOGY DEPARTMENT",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014401336",
            "telephone_number": "997-863-0623",
            "fax_number": "978-630-6353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WACHUSETT RADIOLOGY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A",
        "authorized_official_last_name": "CHEN",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-632-7383",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Diagnostic Radiology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2085R0203X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Therapeutic Radiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "M11539",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Annaliessa Christina Visco
• Kali Han Vo, DMD
• Tina Vo
• Tricia L Vorderstrasse, M.D.
• Huy Duc Vu, RPH
• Wachusett Rehabilitation and Nursing Center LLC
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Bonnie Lyn Waldron, PTA
• Joseph W Walek, MD

• All providers in Gardner, MA
• Diagnostic Radiology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2023; 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.