Individual provider Active NPI

Wayne Edward Pasanen, M.D.

  • Emergency Medicine Physician
  • Lowell, MA
National Provider Identifier
1790727436
Registry record updated May 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
35507 Issued in MA
Practice address
295 Varnum Ave
Lowell General Hospital
Lowell, MA 01854-2134
Phone
(978) 937-6290
Fax
(978) 453-1831
NPI assigned
Jun 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 35507 MA Primary

Addresses

Primary practice location

295 Varnum Ave
Lowell General Hospital
Lowell, MA 01854-2134

Mailing address

117 Osgood St
North Andover, MA 01845-4014
Phone (978) 681-9393

Other identifiers 2

IdentifierTypeStateIssuer
2003805MedicaidMA
B01021OtherMABLUE SHIELD

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

State licenses

LicenseStateTypeSpecialty
35507MAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Jack Chang MD PC PastSince Feb 1, 2012 Accepting new patients
Merrimack Valley Emergency Associates, Inc. Emergency Medicine PastSince Apr 30, 2003 Accepting new patients

Organizations & group practices 2

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": "1149897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210032000000",
    "number": "1790727436",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 OSGOOD ST",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018454014",
            "telephone_number": "978-681-9393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 VARNUM AVE",
            "address_2": "LOWELL GENERAL HOSPITAL",
            "city": "LOWELL",
            "state": "MA",
            "postal_code": "018542134",
            "telephone_number": "978-937-6290",
            "fax_number": "978-453-1831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PASANEN",
        "first_name": "WAYNE",
        "middle_name": "EDWARD",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-10",
        "last_updated": "2008-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "35507",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2003805",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "B01021",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2008; 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.