Individual provider Active NPI

James M Snider, MD

  • Diagnostic Radiology Physician
  • Wellesley Hills, MA
National Provider Identifier
1750351391
Registry record updated Dec 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
58519 Issued in MA
Practice address
165 Worcester St
Wellesley Hills, MA 02481-3615
Phone
(617) 553-5300
NPI assigned
Jan 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2009

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 58519 MA Primary

Addresses

Primary practice location

165 Worcester St
Wellesley Hills, MA 02481-3615

Mailing address

PO Box 9135
Brookline, MA 02446-9135
Phone (603) 893-9784

Other identifiers 3

IdentifierTypeStateIssuer
0107905MedicaidMA
041937OtherMATUFTS
E05247OtherMABLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050829000714 MA Practitioner - Diagnostic Radiology 4880624006 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Rochester School of Medicine and Dentistry, 1976
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Cove Community Health Center, Inc.Group PAC ID 8325939952, 23 clinicians
Breast Imaging Physicians PCGroup PAC ID 5698815355, 3 clinicians

Practice addresses (Care Compare)

145 S St
Boston, MA 02111-2826
Phone (617) 521-6700

165 Worcester St
Wellesley, MA 02481-3615
Phone (617) 553-5300

88 Holmes St
Quincy, MA 02171-2431
Phone (617) 318-3200

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
58519MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
South Cove Community Health Center, Inc. CurrentSince Jul 9, 2008 Accepting new patients
Advantage Imaging Solutions, LLC CurrentSince Mar 1, 2011 Accepting new patients
South Cove Community Health Center, Inc. CurrentSince Jul 9, 2008 Accepting new patients
Breast Imaging Physicians PC Diagnostic Radiology CurrentSince Dec 1, 2009 Accepting new patients

Locations

145 South St
Boston, MA 02111
Phone (617) 521-6700

165 Worcester St
Wellesley Hls, MA 02481
Phone (617) 553-5300

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261612800000",
    "number": "1750351391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9135",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024469135",
            "telephone_number": "603-893-9784",
            "fax_number": "603-893-8886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 WORCESTER ST",
            "city": "WELLESLEY HILLS",
            "state": "MA",
            "postal_code": "024813615",
            "telephone_number": "617-553-5300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SNIDER",
        "first_name": "JAMES",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2009-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "58519",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0107905",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "041937",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "E05247",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellesley Hills, MA

Sources for this page

Verify at the official NPI Registry.