Individual provider Active NPI

Michael G Popik, MD

  • Diagnostic Radiology Physician
  • Leominster, MA
National Provider Identifier
1679512404
Registry record updated Sep 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
052454 Issued in MA
Practice address
60 Hospital Rd
Radiology Department
Leominster, MA 01453-2205
Phone
(978) 466-2685
Fax
(978) 466-2685
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 052454 MA Primary

Addresses

Primary practice location

60 Hospital Rd
Radiology Department
Leominster, MA 01453-2205

Mailing address

12 Partridge Hill Rd
Westminster, MA 01473-1400
Phone (978) 466-2685

Other identifiers 1

IdentifierTypeStateIssuer
6198341MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
052454MAMDDiagnostic Radiology Physician

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188864000000",
    "number": "1679512404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 PARTRIDGE HILL RD",
            "city": "WESTMINSTER",
            "state": "MA",
            "postal_code": "014731400",
            "telephone_number": "978-466-2685",
            "fax_number": "978-466-2693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 HOSPITAL RD",
            "address_2": "RADIOLOGY DEPARTMENT",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014532205",
            "telephone_number": "978-466-2685",
            "fax_number": "978-466-2685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POPIK",
        "first_name": "MICHAEL",
        "middle_name": "G",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2007-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "052454",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6198341",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leominster, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 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.