NPIMap

Organization Active NPI

Congenial Healthcare, LLC

Doing business as Congenial Healthcare Lab

  • Clinical Medical Laboratory
  • Middleton, MA
National Provider Identifier
1659830818
Registry record updated Mar 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
Legal business name
CONGENIAL HEALTHCARE, LLC
Doing business as
Congenial Healthcare Lab
Practice address
147 S Main St
Middleton, MA 01949-2446
Phone
(978) 880-7083
Fax
(978) 880-7193
NPI assigned
Mar 18, 2019
Last updated
Mar 18, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2019

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

Authorized official

Name
Lisa Marie Enderle
Title
Enrollment Manager
Phone
(978) 712-1681

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X NU Primary

Addresses

Primary practice location

147 S Main St
Middleton, MA 01949-2446

Mailing address

1 Roosevelt Ave
Peabody, MA 01960-2200
Phone (978) 536-0215

Other names 1

  • Congenial Healthcare Lab Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20171016002508 MA Part B Supplier - Clinic/Group Practice 5395011522 Receives reassigned benefits from 18 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Wakefield, MA; Lynnfield, MA; Peabody, MA; Lynn, MA

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

1 Roosevelt Ave
Peabody, MA 01960
Phone (978) 535-1110

NPI Registry JSON

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

{
    "created_epoch": "1552867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552867200000",
    "number": "1659830818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ROOSEVELT AVE",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602200",
            "telephone_number": "978-536-0215",
            "fax_number": "978-536-0230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "147 S MAIN ST",
            "city": "MIDDLETON",
            "state": "MA",
            "postal_code": "019492446",
            "telephone_number": "978-880-7083",
            "fax_number": "978-880-7193"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONGENIAL HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-18",
        "last_updated": "2019-03-18",
        "status": "A",
        "authorized_official_last_name": "ENDERLE",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "ENROLLMENT MANAGER",
        "authorized_official_telephone_number": "978-712-1681"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Congenial Healthcare Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Middleton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.