NPIMap

Organization Active NPI

Nephrology Asssociates of the Merrimack Valley PC

  • Nephrology Physician
  • Tewksbury, MA
National Provider Identifier
1700083433
Registry record updated Feb 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
37818 Issued in MA
Legal business name
NEPHROLOGY ASSSOCIATES OF THE MERRIMACK VALLEY PC
Practice address
600 Clark Rd
Tewksbury, MA 01876-1699
Phone
(978) 453-1811
Fax
(978) 452-9111
NPI assigned
Jun 27, 2007
Last updated
Feb 7, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2024

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

Authorized official

Name
Sarah Leduc
Title
Practice Manager
Phone
(978) 453-1811

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology Physician 207RN0300X 37818 MA Primary

Addresses

Primary practice location

600 Clark Rd
Tewksbury, MA 01876-1699

Mailing address

600 Clark Rd
Tewksbury, MA 01876-1699
Phone (978) 453-1811

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050610000415 MA Part B Supplier - Clinic/Group Practice 1153365168 Receives reassigned benefits from 4 practitioners
Practice locations: Tewksbury, MA

National Provider Directory

National Provider Directory

Locations

600 Clark Rd
Tewksbury, MA 01876
Phone (978) 452-3453

600 Clark Rd
#2
Tewksbury, MA 01876
Phone (978) 432-1811

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1182902400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707264000000",
    "number": "1700083433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 CLARK RD",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018761699",
            "telephone_number": "978-453-1811",
            "fax_number": "978-452-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 CLARK RD",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018761699",
            "telephone_number": "978-453-1811",
            "fax_number": "978-452-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEPHROLOGY ASSSOCIATES OF THE MERRIMACK VALLEY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-27",
        "last_updated": "2024-02-07",
        "certification_date": "2024-02-07",
        "status": "A",
        "authorized_official_last_name": "LEDUC",
        "authorized_official_first_name": "SARAH",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "978-453-1811"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "MA",
            "license": "37818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tewksbury, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; 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.