Individual provider Active NPI

Erica Tyler Ghosh, M.D.

  • Diagnostic Radiology Physician
  • Worcester, MA
National Provider Identifier
1760696140
Registry record updated May 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
240529 Issued in MA
Practice address
55 Lake Ave N # S2-824
Worcester, MA 01655-0002
Phone
(508) 856-5381
Fax
(508) 334-5586
NPI assigned
May 9, 2007
Last updated
May 3, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Diagnostic Radiology Physician 2085R0202X 240529 MA Primary

Addresses

Primary practice location

55 Lake Ave N # S2-824
Worcester, MA 01655-0002

Mailing address

55 Lake Ave N # S2-824
Worcester, MA 01655-0002
Phone (508) 856-5381

Other identifiers 1

IdentifierTypeStateIssuer
110085789AMedicaidMA

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
I20100824000642 MA Practitioner - Diagnostic Radiology 1254455504 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Clvlnd Clinic Lerner College of Med of Case WSTN RSV University, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians
Reliant Medical Group IncGroup PAC ID 5597755322, 638 clinicians

Practice addresses (Care Compare)

1 Lyons St
Dedham, MA 02026-5599
Phone (781) 329-1400

133 Brookline Ave
Boston, MA 02215-3904
Phone (617) 421-1000

21 Bristol Dr
South Easton, MA 02375-1199
Phone (774) 302-5700

228 Billerica Rd
Chelmsford, MA 01824-3604
Phone (978) 250-6000

40 Holland St
Somerville, MA 02144-2705
Phone (617) 629-6000

420 Libbey Industrial Pkwy
Weymouth, MA 02189-3134
Phone (781) 331-9880

5 Neponset St
Worcesteer, MA 01606-2714
Phone (508) 595-2300

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
240529MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Massachusetts Regional MRI, Limited Partnership CurrentSince Feb 2, 2015 Accepting new patients
Atrius Health, Inc. CurrentSince Oct 1, 2019 Accepting new patients
Shields Healthcare of Cambridge, Inc. CurrentSince Feb 2, 2015 Accepting new patients
Reliant Medical Group, Inc CurrentSince Feb 1, 2022 Accepting new patients
Atrius Health, Inc. Diagnostic Radiology CurrentSince Oct 1, 2019 Accepting new patients
Bih Radiologic Foundation Inc Diagnostic Radiology Past Accepting new patients

Locations

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051

24 Newton St
Southborough, MA 01772
Phone (508) 460-3190

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

Interoperability endpoints

  • Direct secure messaging: eghoshmd293113@direct.atrius.masshiway.net
  • Direct secure messaging: erica.ghosh.npi1760696140.reliant@direct.optumcare.masshiway.net

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556841600000",
    "number": "1760696140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N # S2-824",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-856-5381",
            "fax_number": "508-334-5586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LAKE AVE N # S2-824",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016550002",
            "telephone_number": "508-856-5381",
            "fax_number": "508-334-5586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GHOSH",
        "first_name": "ERICA",
        "middle_name": "TYLER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2019-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "240529",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110085789A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.