Individual provider Active NPI

Neil Grossman, MD

  • Diagnostic Radiology Physician
  • Wellesley, MA
National Provider Identifier
1568414977
Registry record updated Jan 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
44509 Issued in MA
Practice address
366 Washington St
Wellesley, MA 02481-6206
Phone
(781) 239-0033
Fax
(781) 237-8938
NPI assigned
May 16, 2006
Last updated
Jan 18, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 44509 MA Primary

Addresses

Primary practice location

366 Washington St
Wellesley, MA 02481-6206

Mailing address

91 Stiles Rd
Salem, NH 03079-2846
Phone (603) 890-4404

Other identifiers 1

IdentifierTypeStateIssuer
6164099MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040805001456 MA Practitioner - Diagnostic Radiology 7810967916 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Massachusetts Medical School, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Vincent Radiological Associates IncGroup PAC ID 1850365578, 17 clinicians

Practice addresses (Care Compare)

123 Summer St
Worcester, MA 01608-1216
Phone (978) 939-2035

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
44509MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Gbgastro LLC CurrentSince Jan 1, 2019 Accepting new patients
Greater Boston Gastroenterology CurrentSince Feb 1, 2018 Accepting new patients
Saint Vincent Radiological Associates Inc Diagnostic Radiology CurrentSince Oct 11, 2023 Accepting new patients
Nehe Wsic II LLC Past Accepting new patients
Magnetic Resonance Associates Diagnostic Radiology Past Accepting new patients

Locations

115 Lincoln St
Framingham, MA 01702
Phone (508) 383-1000

475 Franklin St
Ste 110
Framingham, MA 01702
Phone (508) 620-9200

321 Fortune Blvd
Milford, MA 01757
Phone (508) 478-5996

123 Summer St
Worcester, MA 01608
Phone (508) 363-6000

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263772800000",
    "number": "1568414977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "91 STILES RD",
            "city": "SALEM",
            "state": "NH",
            "postal_code": "030792846",
            "telephone_number": "603-890-4404",
            "fax_number": "603-893-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "366 WASHINGTON ST",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024816206",
            "telephone_number": "781-239-0033",
            "fax_number": "781-237-8938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GROSSMAN",
        "first_name": "NEIL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2010-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "44509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6164099",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellesley, MA

Sources for this page

Verify at the official NPI Registry.