NPIMap

Organization Active NPI

Neaai - Wpho LLC

  • Allergy & Immunology Physician
  • Leominster, MA
National Provider Identifier
1740891803
Registry record updated Aug 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
Legal business name
NEAAI - WPHO LLC
Practice address
79 Erdman Way Ste 101
Leominster, MA 01453-1805
Phone
(978) 537-4805
Fax
(978) 537-2185
NPI assigned
Aug 12, 2020
Last updated
Aug 12, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2020

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

Authorized official

Name
Jordan Scott, MDNPI 1275517245
Title
President/Physician
Phone
(978) 537-4805

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Allergy & Immunology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207K00000X Primary

Addresses

Primary practice location

79 Erdman Way Ste 101
Leominster, MA 01453-1805

Mailing address

79 Erdman Way Ste 101
Leominster, MA 01453-1805
Phone (978) 537-4805

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260415001739 MA Part B Supplier - Clinic/Group Practice 9638645963 Receives reassigned benefits from 5 practitioners
Practice locations: Concord, MA; Worcester, MA; Sudbury, MA; Leominster, MA; Newton, MA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

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": "1597190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597190400000",
    "number": "1740891803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 ERDMAN WAY STE 101",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014531805",
            "telephone_number": "978-537-4805",
            "fax_number": "978-537-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 ERDMAN WAY STE 101",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "014531805",
            "telephone_number": "978-537-4805",
            "fax_number": "978-537-2185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEAAI - WPHO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-12",
        "last_updated": "2020-08-12",
        "certification_date": "2020-08-12",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_title_or_position": "PRESIDENT/PHYSICIAN",
        "authorized_official_telephone_number": "978-537-4805",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Aug 12, 2020; 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.