NPIMap

Organization Active NPI

Heywood Medical Group Inc.

  • General Practice Physician
  • Gardner, MA
National Provider Identifier
1699762286
Registry record updated Jun 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
HEYWOOD MEDICAL GROUP INC.
Practice address
242 Green St
Gardner, MA 01440-1336
Phone
(978) 630-5076
Fax
(978) 630-5079
NPI assigned
Sep 29, 2005
Last updated
Jun 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2023

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

Authorized official

Name
Thomas J Sullivan
Title
Ceo
Phone
(978) 630-6157

Specialties & licenses 15

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X NU
Family Nurse Practitioner 363LF0000X NU
Anesthesiology Physician 207L00000X NU
Family Medicine Physician 207Q00000X MA
Internal Medicine Physician 207R00000X MA
Cardiovascular Disease Physician 207RC0000X MA
Gastroenterology Physician 207RG0100X NU
Hematology & Oncology Physician 207RH0003X NU
Pulmonary Disease Physician 207RP1001X NU
Obstetrics & Gynecology Physician 207V00000X NU
Orthopaedic Surgery Physician 207X00000X NU
Pediatrics Physician 208000000X NU
Neurology Physician 2084N0400X NU
Urology Physician 208800000X 238888 MA
General Practice Physician 208D00000X MA Primary

Addresses

Primary practice location

242 Green St
Gardner, MA 01440-1336

Mailing address

242 Green St
Gardner, MA 01440-1336
Phone (978) 630-5072

Other identifiers 1

IdentifierTypeStateIssuer
9768688MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20040322000360 MA Part B Supplier - Clinic/Group Practice 1658262605 Receives reassigned benefits from 369 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gardner, MA; Petersham, MA; Winchendon, MA
O20040629001351 MA Part B Supplier - Clinic/Group Practice 6901882836 Receives reassigned benefits from 236 practitioners
3 other NPIs on this enrollment
Practice locations: Athol, MA; Gardner, MA
O20050329001065 MA Part A Provider - Hospital 1658262605 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Gardner, MA; Winchendon, MA
O20200129002150 NH Part B Supplier - Clinic/Group Practice 6901882836 Receives reassigned benefits from 2 practitioners
Practice locations: Rindge, NH

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1699762286. Details of each certification follow.

Hospital certification: CCN 220095

Legal name
HENRY HEYWOOD MEMORIAL HOSPITAL
Doing business as
HEYWOOD HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Jul 1, 1966
Last certification
Aug 28, 2002
Beds
134
Ownership / control type
Private (not for profit)
Organization structure
CorporationNon-profit
Incorporated
May 14, 1907 in MA
Enrollment address
242 Green St
Gardner, MA 14401336
Main/Primary Hospital Location
Hospital subgroups
General, Acute care, Psychiatric

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 5

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

Care Compare: Hospital

Medicare Care Compare
Listed as
Heywood Hospital -CCN 220095 · All quality measures
Overall star rating
2 of 5
Type
Acute Care Hospitals
Ownership
Voluntary non-profit - Private
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory

Member organizations 2

Organizations listed as members of this organization in the National Provider Directory.

Locations

266 Main St
Gardner, MA 01440
Phone (978) 630-5030

Ownership & related parties

All disclosed owners & managing parties 19

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Craig S Twohey Individual Corporate Director Feb 1, 2015
Joanne a Parks Individual Corporate Director Dec 31, 2012
Erin C O'Hara Individual Corporate Director Jan 1, 2022
Frank W Sweeney Individual Corporate Director Jan 1, 2022
Albert S Rose Individual Corporate Director Jan 25, 2018
John Bujak Individual Corporate OfficerCfo Aug 1, 2024
Corporate DirectorCfo Aug 1, 2024
W-2 Managing EmployeeAd; Aug 1, 2024
David Spackman Individual Corporate Director May 30, 2019
Roy V Lake Individual Corporate Director Dec 31, 2012
Nicole Moorshead Individual Corporate Director Jan 1, 2020
Heywood Healthcare Inc Organization, Gardner, MA Non-profit Operational/Managerial Control Sep 6, 2013
Tina M Sbrega Individual Corporate Director Dec 31, 2012
Thomas Kane Individual Corporate Director Jan 1, 2020
Cheney M Castine Individual Corporate Director Dec 31, 2012
Glenn a Hunt Individual Corporate Director Dec 31, 2012
John M Skrzypczak Individual Corporate Director Dec 31, 2012
Robert F Chauvin Individual Corporate Director Dec 31, 2012
Craig Anthony Napolitano Individual Corporate Director Jan 1, 2021
Joel R Shaughnessy Individual Corporate Director Dec 31, 2012
Joyce C Fletcher Individual Corporate Director Dec 31, 2012

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 285

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 285

Affiliated clinicians 353

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 353

NPI Registry JSON

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686182400000",
    "number": "1699762286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 GREEN ST",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014401336",
            "telephone_number": "978-630-5072",
            "fax_number": "978-630-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 GREEN ST",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014401336",
            "telephone_number": "978-630-5076",
            "fax_number": "978-630-5079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEYWOOD MEDICAL GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-29",
        "last_updated": "2023-06-08",
        "certification_date": "2023-06-08",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "978-630-6157"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MA",
            "license": "238888",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9768688",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardner, MA

Sources for this page

Verify at the official NPI Registry.