NPIMap

Individual provider Active NPI

Lacey J McIntosh, D.O., M.P.H.

  • Diagnostic Radiology Physician
  • Worcester, MA
National Provider Identifier
1568773992
Registry record updated Jun 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
265041 Issued in MA
Practice address
55 Lake Ave N
Worcester, MA 01655-0002
Phone
(508) 334-3850
NPI assigned
Jun 30, 2010
Last updated
Jun 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2021

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 265041 MA Primary

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 identifiers 1

IdentifierTypeStateIssuer
110110486AMedicaidMA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address lmcintosh19477@UmassMemorial.direct-ci.com
FHIR URL https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, ME2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160609000414 MA Practitioner - Diagnostic RadiologyPractitioner - Internal Medicine 1355631060 Reassigns benefits to 3 organizations
I20230206001231 ME Practitioner - Diagnostic Radiology 1355631060 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of New England, College of Osteo Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Umass Memorial Radiology Phys ServGroup PAC ID 6800868779, 40 clinicians
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

20 Prospect St
Milford, MA 01757-3042
Phone (508) 488-3700

340 Thompson Rd
Webster, MA 01570-1509
Phone (508) 856-5381

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 Osteopathy

State licenses

LicenseStateTypeSpecialty
265041MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial MRI & Imaging Center, LLC CurrentSince Jan 11, 2024 Accepting new patients
Umass Memorial MRI & Imaging Center LLC CurrentSince Aug 1, 2016 Accepting new patients
Mass General Brigham Medical Group Western Massachusetts Inc Internal Medicine CurrentSince Jun 26, 2023 Accepting new patients
York Hospital CurrentSince Jan 1, 2023 Accepting new patients
Cooley Dickinson Hospital Inc Current Accepting new patients
Umass Memorial MRI & Imaging Center, LLC CurrentSince Jan 29, 2019 Accepting new patients
Umass Memorial Radiology Phys Serv Diagnostic Radiology CurrentSince Jul 1, 2016 Accepting new patients
Umass Memorial MRI & Imaging Center, LLC Diagnostic Radiology CurrentSince Aug 1, 2016 Accepting new patients
Umass Memorial MRI & Imaging Center, LLC CurrentSince Aug 1, 2016 Accepting new patients
Umass Memorial Medical Group Inc Internal Medicine CurrentSince May 1, 2021 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince May 1, 2021 Accepting new patients
Shields Imaging at Heywood Healthcare LLC PastSince Sep 1, 2022 Accepting new patients

Locations

30 Locust St
Northampton, MA 01060
Phone (413) 582-2000

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

10 Little Brook Rd
West Wareham, MA 02576

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

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

15 Hospital Dr
York, ME 03909
Phone (207) 351-2478

Interoperability endpoints

  • Direct secure messaging: lmcintosh19477@umassmemorial.direct-ci.com
  • Direct secure messaging: mcintosh.lacey.cdh@direct.partners.masshiway.net

Organizations & group practices 12

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 4

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": "1277856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1568773992",
    "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": [],
    "basic": {
        "last_name": "MCINTOSH",
        "first_name": "LACEY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.O., M.P.H.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-30",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "265041",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110110486A",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lmcintosh19477@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "55 Lake Ave N",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016550002",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "55 Lake Ave N",
            "city": "Worcester",
            "state": "MA",
            "country_code": "US",
            "postal_code": "016550002",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.