Massachusetts Mobile Pet PC

Primary specialty

Mobile Radiology Clinic/CenterTaxonomy code 261QR0208X

License

44-0373 Issued in MA

Legal business name

MASSACHUSETTS MOBILE PET PC

Practice address

140 Lincoln Ave
Haverhill, MA 01830-6700

Phone

(978) 689-4738

Fax

(978) 682-0984

NPI assigned

May 25, 2006

Last updated

Jan 16, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark R Taylor

Title

Ceo

Phone

(978) 933-9311

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Merrimack Valley Pet PC

  dba New England PET Imaging System

  • Mobile Radiology Clinic/Center
  • Manchester, NH
  • NPI 1922055094

  Member Of

  NPD member

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Samantha Harrington

  • Nuclear Radiology Physician
  • Boston, MA
  • NPI 1255795407
  NPD

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736985600000",
    "number": "1861448797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 NEW ENGLAND BUSINESS CENTER DR STE 103",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018101080",
            "telephone_number": "978-933-9302",
            "fax_number": "978-933-7820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 LINCOLN AVE",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018306700",
            "telephone_number": "978-689-4738",
            "fax_number": "978-682-0984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASSACHUSETTS MOBILE PET PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2025-01-16",
        "certification_date": "2025-01-16",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "978-933-9311"
    },
    "taxonomies": [
        {
            "code": "261QR0208X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Radiology, Mobile",
            "state": "MA",
            "license": "44-0373",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "972781",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "696200",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "706023",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH",
            "identifier": "0032507",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3137889",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS OF MA",
            "identifier": "M18139",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mass General Brigham Community Physicians Inc
• Mass General Brigham Community Physicians Inc
• Mass General Brigham Community Physicians Inc. (Pentucket Medical)
• Mass General Brigham Community Physicians Inc.
• Mass General Brigham Medical Group Northern Massachusetts Inc (MGB Pathology - PMA Lab)
• Claudine Massena, LMHC
• Isabel Mateo, THERAPEUTIC MENTOR
• Jason Mathai
• Lisa Matheson, THERAPEUTIC MENTOR
• Hannah Marie Matsubara

• Mobile Radiology Clinic/Center in Haverhill, MA
• Providers in Haverhill, MA by specialty
• Mobile Radiology Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.