NPIMap

Individual provider Active NPI

Bruce P Hall, MD

  • Diagnostic Radiology Physician
  • Billerica, MA
National Provider Identifier
1780646190
Registry record updated Aug 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
227876 Issued in MA
Practice address
5 Riverhurst Rd
Apt. 716
Billerica, MA 01821-3412
Phone
(716) 480-3624
NPI assigned
Apr 3, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 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 227876 MA Primary

Addresses

Primary practice location

5 Riverhurst Rd
Apt. 716
Billerica, MA 01821-3412

Mailing address

5 Riverhurst Rd
Apt. 716
Billerica, MA 01821
Phone (716) 480-3624

Other identifiers 2

IdentifierTypeStateIssuer
01805316MedicaidNY
2122553MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southtowns Radiology Associates, LLC Diagnostic Radiology Past Accepting new patients
Sra Medical Imaging LLC Diagnostic Radiology Past Accepting new patients
MRI Radiologists of the N Shore Inc Diagnostic Radiology Past Accepting new patients
Diagnostic Imaging Associates LLP Diagnostic Radiology Past Accepting new patients
Southtowns Radiology Associates, LLC Diagnostic Radiology Past Accepting new patients
Nuclear Medicine Associates RLLP Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251676800000",
    "number": "1780646190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 RIVERHURST RD",
            "address_2": "APT. 716",
            "city": "BILLERICA",
            "state": "MA",
            "postal_code": "01821",
            "telephone_number": "716-480-3624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 RIVERHURST RD",
            "address_2": "APT. 716",
            "city": "BILLERICA",
            "state": "MA",
            "postal_code": "018213412",
            "telephone_number": "716-480-3624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "BRUCE",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2009-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "227876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01805316",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2122553",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Billerica, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2009; 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.