NPIMap

Organization Active NPI

MMDS of Boston, LLC

  • Portable X-ray and/or Other Portable Diagnostic Imaging Supplier
  • Norwood, MA
National Provider Identifier
1871672048
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Portable X-ray and/or Other Portable Diagnostic Imaging SupplierTaxonomy code 335V00000X
Legal business name
MMDS OF BOSTON, LLC
Practice address
57 Providence Hwy Ste 201
Norwood, MA 02062-2645
Phone
(617) 244-9729
Fax
(617) 244-9730
NPI assigned
Nov 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Authorized official

Name
Richard Scott Grinley
Title
Owner
Phone
(617) 633-5758

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Portable X-ray and/or Other Portable Diagnostic Imaging Supplier 335V00000X Primary

Addresses

Primary practice location

57 Providence Hwy Ste 201
Norwood, MA 02062-2645

Mailing address

57 Providence Hwy Ste 201
Norwood, MA 02062-2645
Phone (617) 244-9729

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH4 enrollments

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
O20061222000101 MA Part B Supplier - Portable X-Ray Supplier 2163422106 Practice locations: Norwood, MA
O20160405000930 NH Part B Supplier - Portable X-Ray Supplier 2163422106 Practice locations: Manchester, NH
O20220412002586 MA Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 2163422106 Practice locations: Norwood, MA
O20250708000650 NH Part B Supplier - Independent Diagnostic Testing Facility (Idtf) 2163422106 Practice locations: Manchester, NH

National Provider Directory

National Provider Directory
Tax ID family
MMDS of Boston LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

57 Providence Hwy
Ste 201
Norwood, MA 02062
Phone (617) 244-9729

Practitioners & affiliated clinicians

Practitioners 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674086400000",
    "number": "1871672048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 PROVIDENCE HWY STE 201",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020622645",
            "telephone_number": "617-244-9729",
            "fax_number": "617-244-9730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 PROVIDENCE HWY STE 201",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020622645",
            "telephone_number": "617-244-9729",
            "fax_number": "617-244-9730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMDS OF BOSTON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A",
        "authorized_official_last_name": "GRINLEY",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "617-633-5758"
    },
    "taxonomies": [
        {
            "code": "335V00000X",
            "taxonomy_group": "",
            "desc": "Portable X-ray and/or Other Portable Diagnostic Imaging Supplier",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwood, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; 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.