Mass General Brigham Medical Group Suburban Massachusetts Inc

Organization Active NPI Clinical Medical Laboratory · South Weymouth, MA

NPI 1699622134 · NPPES record last updated Mar 27, 2026

Key facts

NPI
1699622134
Entity type
Organization (NPI type 2)
Primary specialty
Clinical Medical Laboratory 291U00000X
Legal business name
MASS GENERAL BRIGHAM MEDICAL GROUP SUBURBAN MASSACHUSETTS INC
Practice address
541 Main St Ste 420
South Weymouth, MA 02190-1889
Phone
(781) 952-1367
NPI assigned
Mar 13, 2026
Organization subpart
No

Authorized official

Name
Joanna Hazell
Title
Director, Rco Provider Enrollment
Phone
(781) 254-4854

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 1

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

Practitioners 534

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

View all 534

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D0689168MGB Pathology - Hma Main Lab
541 Main Street Ste 420, South Weymouth, MA 02190
AccreditationSep 15, 2027
22D1097936Mass General Brigham (South Weymouth)
541 Main Street, Weymouth, MA 02190
Provider-performed microscopyNov 2, 2027

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20260423000604 MA Part B Supplier - Independent Clinical Laboratory 0244133494 Practice locations: South Weymouth, MA

National Provider Directory

Tax ID family
Newton Wellesley Ambula (2 organizations share this tax ID)

Locations

101 Columbian St
Rm 364
South Weymouth, MA 02190
Phone (781) 952-1367

541 Main St
Weymouth, MA 02190
Phone (781) 331-7866

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X Yes

Addresses

Primary practice location

541 Main St Ste 420
South Weymouth, MA 02190-1889

Mailing address

399 Revolution Dr Ste 580
Somerville, MA 02145-1572
Phone (617) 726-3884

Other practice location 1

101 Columbian St Rm 364
South Weymouth, MA 02190-1601
Phone (781) 952-1367

Other names

  • MGB Pathology - HMA Main Lab Doing business as

Other providers in South Weymouth, MA

All providers in South Weymouth, MA · Clinical Medical Laboratory in Massachusetts

Sources for this page

Verify at the official NPI Registry.