NPIMap

Organization Active NPI

Riverside Surgical Associates, PC

  • Surgery Physician
  • Lowell, MA
National Provider Identifier
1538405378
Registry record updated Nov 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
235823 Issued in MA
Legal business name
RIVERSIDE SURGICAL ASSOCIATES, PC
Practice address
275 Varnum Ave Ste 203
Lowell, MA 01854-2109
Phone
(978) 458-4300
Fax
(978) 458-4311
NPI assigned
Dec 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2023

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

Authorized official

Name
Wassim Mazraany, MDNPI 1700952314
Title
President
Phone
(978) 458-4300

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
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 235823 MA Primary

Addresses

Primary practice location

275 Varnum Ave Ste 203
Lowell, MA 01854-2109

Mailing address

10 Little Brook Rd
West Wareham, MA 02576-1222
Phone (800) 841-5200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130401000159 MA Part B Supplier - Clinic/Group Practice 8123263837 Receives reassigned benefits from 9 practitioners
Practice locations: North Chelmsford, MA; Lowell, MA

National Provider Directory

National Provider Directory

Locations

1 Hospital Dr
#30
Lowell, MA 01852

275 Varnum Ave
Ste 203
Lowell, MA 01854
Phone (978) 458-4300

20 Research Pl
North Chelmsford, MA 01863
Phone (978) 788-7200

20 Research Pl
Ste 120
North Chelmsford, MA 01863

Practitioners & affiliated clinicians

Practitioners 11

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

NPI Registry JSON

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

{
    "created_epoch": "1356480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701302400000",
    "number": "1538405378",
    "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": "275 VARNUM AVE STE 203",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018542109",
            "telephone_number": "978-458-4300",
            "fax_number": "978-458-4311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERSIDE SURGICAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-26",
        "last_updated": "2023-11-30",
        "certification_date": "2023-11-30",
        "status": "A",
        "authorized_official_last_name": "MAZRAANY",
        "authorized_official_first_name": "WASSIM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "978-458-4300",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "MA",
            "license": "235823",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

  • 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.
  • 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.