Medigroup PC

Primary specialty

Sports Medicine (Neuromusculoskeletal Medicine) PhysicianTaxonomy code 204C00000X

License

54262 Issued in MA

Legal business name

MEDIGROUP PC

Practice address

4 Frank Leary Way
Randolph, MA 02368-4512

Phone

(781) 986-1737

Fax

(781) 986-0507

NPI assigned

Aug 23, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Mark Weiner, M.D.

Title

Owner

Phone

(781) 986-1737

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189382400000",
    "number": "1669588372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 FRANK LEARY WAY",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 FRANK LEARY WAY",
            "city": "RANDOLPH",
            "state": "MA",
            "postal_code": "023684512",
            "telephone_number": "781-986-1737",
            "fax_number": "781-986-0507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIGROUP PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-23",
        "last_updated": "2007-09-10",
        "status": "A",
        "authorized_official_last_name": "WEINER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-986-1737",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "204C00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neuromusculoskeletal Medicine, Sports Medicine",
            "state": "MA",
            "license": "54262",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9725288",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ruth A McLain, M.D.
• Ashley McLeod
• Kelly McLeod
• Xavier P McRae
• Me la Vang Community Health Services, LLC
• Jolie Vilmeli Medrano
• Jerilynn Mejia
• Sabah Ahmed Mekki Mahadi, DMD
• Rachel Mendelsohn
• Lidiana Mendes

• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Randolph, MA
• Providers in Randolph, MA by specialty
• Sports Medicine (Neuromusculoskeletal Medicine) Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2007; 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.