NPIMap

Organization Active NPI

Premise Health of Massachusetts, Medical PC

  • Occupational Medicine Clinic/Center
  • Burlington, MA
National Provider Identifier
1619238797
Registry record updated Aug 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational Medicine Clinic/CenterTaxonomy code 261QX0100X
Legal business name
PREMISE HEALTH OF MASSACHUSETTS, MEDICAL PC
Practice address
41 Mall Rd
Burlington, MA 01805-0001
Phone
(781) 744-8796
Fax
(781) 744-5044
NPI assigned
Jun 5, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2022

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

Authorized official

Name
Jon Leizman, M.D.
Title
President
Phone
(216) 479-9063

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X
Occupational Medicine Clinic/Center 261QX0100X Primary

Addresses

Primary practice location

41 Mall Rd
Burlington, MA 01805-0001

Mailing address

5500 Maryland Way
Brentwood, TN 37027-4948
Phone (877) 865-9013

Other names 1

  • Lahey Clinic- Employee Health Department Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Premise Health of Massachusetts Medical PC11 organizations share this tax ID, including this one

Other organizations with this tax ID 10

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1338854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1661299200000",
    "number": "1619238797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 MARYLAND WAY",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274948",
            "telephone_number": "877-865-9013",
            "fax_number": "217-709-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 MALL RD",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018050001",
            "telephone_number": "781-744-8796",
            "fax_number": "781-744-5044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMISE HEALTH OF MASSACHUSETTS, MEDICAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-05",
        "last_updated": "2022-08-24",
        "certification_date": "2022-08-24",
        "status": "A",
        "authorized_official_last_name": "LEIZMAN",
        "authorized_official_first_name": "JON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "216-479-9063",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lahey Clinic- Employee Health Department",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lahey Clinic- Employee Health Department",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Burlington, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2022; 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.