NPIMap

Organization Active NPI

Umass Memorial Medical Group, Inc.

  • Radiation Oncology Physician
  • Methuen, MA
National Provider Identifier
1760155584
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiation Oncology PhysicianTaxonomy code 2085R0001X
Legal business name
UMASS MEMORIAL MEDICAL GROUP, INC.
Practice address
70 East St
Methuen, MA 01844-4597
Phone
(978) 687-0151
NPI assigned
Jul 28, 2021
Last updated
Jul 28, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
UMASS MEMORIAL MEDICAL GROUP, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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

Authorized official

Name
Debra M Wooldridge
Title
Supervisor Provider Enrollment
Phone
(508) 334-8890

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiation Oncology Physician 2085R0001X NU Primary

Addresses

Primary practice location

70 East St
Methuen, MA 01844-4597

Mailing address

281 Lincoln Street
Provider Enrollment
Worcester, MA 02241-2138
Phone (508) 334-8890

Other names 1

  • UMMMG - Radiation Oncology Other name

National Provider Directory

National Provider Directory
Tax ID family
Univ Mass Group Practic6 organizations share this tax ID, including this one
Part of
Univ Mass Group Practic

Other organizations with this tax ID 5

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

NPI Registry JSON

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627430400000",
    "number": "1760155584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "281 LINCOLN STREET",
            "address_2": "PROVIDER ENROLLMENT",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "022412138",
            "telephone_number": "508-334-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 EAST ST",
            "city": "METHUEN",
            "state": "MA",
            "postal_code": "018444597",
            "telephone_number": "978-687-0151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UMASS MEMORIAL MEDICAL GROUP, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UMASS MEMORIAL MEDICAL GROUP, INC.",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-06-30",
        "status": "A",
        "authorized_official_last_name": "WOOLDRIDGE",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SUPERVISOR PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "508-334-8890"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "UMMMG - Radiation Oncology",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Methuen, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.