Mark Alan Radzicki, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

40489 Issued in MA

Practice address

77 Boylston Street
Springfield, MA 01104

Phone

(413) 734-8254

Fax

(413) 747-5870

NPI assigned

Mar 2, 2006

Last updated

Apr 5, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Riverbend Medical Group, Inc.

  dba Trinity Health Of New England Medical Group

  • Internal Medicine Physician
  • Springfield, MA
  • NPI 1841651197
  Medicare reassignment NPD
• Riverbend Medical Group, Inc

  dba Trinity Health Of New England Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Springfield, MA
  • NPI 1265023154
  NPD
• The Mercy Hospital Inc

  dba Providence Behavioral Health Hospital

  • Psychiatric Hospital
  • Holyoke, MA
  • NPI 1629062906
  NPD (past)

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333584000000",
    "number": "1598732281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "354 BIRNIE AVE",
            "address_2": "HAMPDEN COUNTY PHYSICIAN ASSOCIATES",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071108",
            "telephone_number": "413-733-3470",
            "fax_number": "413-733-5235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 BOYLSTON STREET",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "01104",
            "telephone_number": "413-734-8254",
            "fax_number": "413-747-5870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RADZICKI",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2012-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "40489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30013000",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicholas Radigan, MD
• Radiology & Imaging Inc
• Radiology & Imaging, Inc.
• Radiology and Imaging, Inc.
• Shannon L Radlo, LCSW
• Kailey Radziszewski
• Sandra J Rae, RNC,WHNP
• Rafa Transportation
• Aneta B Rafalowski, M.D.
• Seamus Rafferty, MD

• Internal Medicine Physician in Springfield, MA
• Providers in Springfield, MA by specialty
• Internal Medicine Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.