Individual provider Active NPI

Mark J Brenner, MD

  • Diagnostic Radiology Physician
  • Worcester, MA
National Provider Identifier
1902873409
Registry record updated May 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
54099 Issued in MA
Practice address
1 Eaton PL Ste 100
Worcester, MA 01608
Phone
(508) 363-6881
Fax
(508) 363-7170
NPI assigned
Mar 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 54099 MA Primary
Radiation Oncology Physician 2085R0001X D0041640 MD

Addresses

Primary practice location

1 Eaton PL Ste 100
Worcester, MA 01608

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885

Other practice location 1

20 Washington Sq
Worcester, MA 01604-4013
Phone (508) 363-6218

Other practice location 2

275 Nichols Rd
Fitchburg, MA 01420-1919
Phone (978) 343-5151

Other identifiers 4

IdentifierTypeStateIssuer
110085074AMedicaidMA
920007556OtherMDRAILROAD MEDICARE
168741700MedicaidMD
920004528OtherMDRR MEDICARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, WI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20100609000419 MA Practitioner - Radiation Oncology 7618877507 Reassigns benefits to 2 organizations
I20260309002139 WI Practitioner - Radiation Oncology 7618877507 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Radiation Oncology
Education
Tufts University School of Medicine, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Vincent Physician Services IncGroup PAC ID 8921056276, 71 clinicians
The Monroe Clinic, Inc.Group PAC ID 3072425495, 199 clinicians

Practice addresses (Care Compare)

123 Summer St
Worcester, MA 01608-1216

515 22ND Ave
Monroe, WI 53566-1569
Phone (608) 324-2000

Hospital & facility affiliations

  • St Vincent Hospital Hospital, Worcester, MA, CCN 220176
  • The Monroe Clinic Hospital, Monroe, WI, CCN 520028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
D0041640MDMDRadiation Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Monroe Clinic, Inc. CurrentSince Feb 26, 2026 Accepting new patients
The Monroe Clinic, Inc. CurrentSince Feb 26, 2026 Accepting new patients
Saint Vincent Physician Services, Inc. CurrentSince May 3, 2010 Accepting new patients
Northwest Baltimore Radiation Therapy Regional Center, LLC Radiation Oncology Past Accepting new patients
VHM Services, Inc. Past Accepting new patients
Radiation Oncology Services of Northwest Baltimore, LLC Radiation Oncology PastSince Aug 1, 1998 Accepting new patients
American Radiology Associates, P.a. Diagnostic Radiology Past Accepting new patients

Locations

123 Summer St
#273
Worcester, MA 01608
Phone (508) 363-6327

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

1 Eaton Pl
Ste 100
Worcester, MA 01608
Phone (508) 363-6881

515 22nd Ave
Monroe, WI 53566
Phone (608) 324-1000

Organizations & group practices 8

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1779753600000",
    "number": "1902873409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885",
            "fax_number": "508-334-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 EATON PL STE 100",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "01608",
            "telephone_number": "508-363-6881",
            "fax_number": "508-363-7170"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "20 Washington Sq",
            "address_purpose": "LOCATION",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016044013",
            "country_code": "US",
            "telephone_number": "508-363-6218",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "275 Nichols Rd",
            "address_purpose": "LOCATION",
            "city": "Fitchburg",
            "state": "MA",
            "postal_code": "014201919",
            "country_code": "US",
            "telephone_number": "978-343-5151",
            "fax_number": "774-442-5006",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRENNER",
        "first_name": "MARK",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2026-05-26",
        "certification_date": "2026-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "54099",
            "primary": true
        },
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MD",
            "license": "D0041640",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110085074A",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "920007556",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "168741700",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "920004528",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.