NPIMap

Premier Diagnostic Services, Inc

Organization Active NPI Sonography Radiologic Technologist · Stoughton, MA

NPI 1659377802 · NPPES record last updated Mar 20, 2023

Key facts

NPI
1659377802
Entity type
Organization (NPI type 2)
Primary specialty
Sonography Radiologic Technologist 2471S1302X
Legal business name
PREMIER DIAGNOSTIC SERVICES, INC
Practice address
378 Page St.
Suite 101
Stoughton, MA 02072-1124
Phone
(800) 346-2111
Fax
(508) 584-6362
NPI assigned
Jun 22, 2005
Organization subpart
No

Authorized official

Name
Mr. Bryon L Becker
Title
VP
Phone
(508) 584-5600

Practitioners 112

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

View all 112

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040426001462 MA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 2062308059 Practice locations: Stoughton, MA

National Provider Directory

Locations (25 of 39)

411 Massachusetts Ave
Ste 202
Acton, MA 01720
Phone (978) 635-0477

54 Bodwell St
Ste C
Avon, MA 02322

800 W Main St
Avon, MA 02322
Phone (508) 584-5600

54 Bodwell St
#C
Avon, MA 02322

54 Bodwell St
Avon, MA 02322
Phone (800) 346-2111

190 Groton Rd
Ste 107
Ayer, MA 01432
Phone (978) 772-5419

45 Francis St
#11
Boston, MA 02115
Phone (617) 732-6325

830 Oak St
Brockton, MA 02301
Phone (508) 427-2222

830 Oak St
Ste 233E
Brockton, MA 02301
Phone (508) 586-6053

59 Ornac
Concord, MA 01742
Phone (978) 287-4788

450 Maple St
Danvers, MA 01923
Phone (978) 744-5000

10 Carematrix Dr
Dedham, MA 02026
Phone (781) 461-9663

66 Central St
#H
East Bridgewater, MA 02333
Phone (508) 378-7227

10 Prospect St
Fitchburg, MA 01420
Phone (978) 345-5827

253 Pleasant Lake Ave
Harwich, MA 02645
Phone (508) 432-5233

431 Pond St
Jamaica Plain, MA 02130
Phone (617) 522-2600

50 Memorial Dr
Ste 104
Leominster, MA 01453
Phone (978) 466-4075

60 Hospital Rd
Bldg G
Leominster, MA 01453
Phone (978) 534-0060

531 King St
Littleton, MA 01460
Phone (978) 742-5999

295 Varnum Ave
#M
Lowell, MA 01854
Phone (978) 459-8300

275 Varnum Ave
Ste 201
Lowell, MA 01854
Phone (978) 452-9700

320 Bolton St
Marlborough, MA 01752
Phone (508) 460-9670

532 Lebanon St
Melrose, MA 02176
Phone (617) 665-3237

411 Merrimack St
Methuen, MA 01844
Phone (603) 421-2018

21 School St
Ofc Of
Quincy, MA 02169
Phone (617) 472-2697

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiology Technician
Group: 193200000X MULTI-SPECIALTY GROUP		 246W00000X
Sonography Specialist/Technologist Cardiovascular
Group: 193200000X MULTI-SPECIALTY GROUP		 246XS1301X
EEG Specialist/Technologist
Group: 193200000X MULTI-SPECIALTY GROUP		 246ZE0500X
Bone Densitometry Radiologic Technologist
Group: 193200000X MULTI-SPECIALTY GROUP		 2471B0102X
Sonography Radiologic Technologist
Group: 193200000X MULTI-SPECIALTY GROUP		 2471S1302X Yes
Vascular Sonography Radiologic Technologist
Group: 193200000X MULTI-SPECIALTY GROUP		 2471V0105X

Addresses

Primary practice location

378 Page St.
Suite 101
Stoughton, MA 02072-1124

Mailing address

378 Page St.
Suite 101
Stoughton, MA 02072-1124
Phone (800) 346-2111

Other identifiers

IdentifierTypeStateIssuer
1526260MedicaidMA
1850091MedicaidMA
76Y00737NH01OtherNHNH ANTHEM BC PROV
041169OtherMABCMA IPDL#
327019OtherMAMA BC PROV

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 20, 2023.

{
    "created_epoch": "1119398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679270400000",
    "number": "1659377802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "378 PAGE ST.",
            "address_2": "SUITE 101",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020721124",
            "telephone_number": "800-346-2111",
            "fax_number": "508-584-6362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "378 PAGE ST.",
            "address_2": "SUITE 101",
            "city": "STOUGHTON",
            "state": "MA",
            "postal_code": "020721124",
            "telephone_number": "800-346-2111",
            "fax_number": "508-584-6362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER DIAGNOSTIC SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-22",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A",
        "authorized_official_last_name": "BECKER",
        "authorized_official_first_name": "BRYON",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "508-584-5600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "246W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Technician, Cardiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "246XS1301X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist Cardiovascular, Sonography",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "246ZE0500X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist/Technologist, Other, EEG",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2471B0102X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Bone Densitometry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2471S1302X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Sonography",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2471V0105X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Radiologic Technologist, Vascular Sonography",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1526260",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1850091",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NH ANTHEM BC PROV",
            "identifier": "76Y00737NH01",
            "state": "NH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCMA IPDL#",
            "identifier": "041169",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MA BC PROV",
            "identifier": "327019",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoughton, MA

All providers in Stoughton, MA · Sonography Radiologic Technologist in Massachusetts

Sources for this page

Verify at the official NPI Registry.