NPIMap

Individual provider Active NPI

Russell S. Zide, M.D.

  • Internal Medicine Physician
  • Burlington, MA
National Provider Identifier
1912012329
Registry record updated Apr 23, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
153035 Issued in MA
Practice address
41 Mall Rd.
Lahey Clinic
Burlington, MA 01805-0001
Phone
(781) 744-7000
Fax
(781) 744-5236
NPI assigned
Aug 19, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 153035 MA Primary

Addresses

Primary practice location

41 Mall Rd.
Lahey Clinic
Burlington, MA 01805-0001

Mailing address

41 Mall Rd.
Lahey Clinic
Burlington, MA 01805-0001
Phone (781) 744-7000

Other identifiers 1

IdentifierTypeStateIssuer
110059914AMedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100528000103 MA Practitioner - Internal MedicinePractitioner - Other (Physician) 8325177421 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Boston University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Emerson Practice Associates, IncGroup PAC ID 8123188117, 247 clinicians

Practice addresses (Care Compare)

133 Old Rd to 9 Acre Cor
Concord, MA 01742-4159
Phone (978) 287-3020

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
153035MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Emerson Practice Associates, Inc. Internal Medicine CurrentSince Aug 30, 2018 Accepting new patients
Winchester Physician Associates, Inc Internal Medicine Past Accepting new patients

Locations

55 North Rd
Ste 120
Bedford, MA 01730
Phone (339) 215-5100

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

133 Ornac
Concord, MA 01742
Phone (978) 287-3000

Interoperability endpoints

  • Direct secure messaging: zide.russell.epa@direct.partners.masshiway.net

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.

Hospital & facility affiliations 9

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": "1155945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1366675200000",
    "number": "1912012329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 MALL RD.",
            "address_2": "LAHEY CLINIC",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018050001",
            "telephone_number": "781-744-7000",
            "fax_number": "781-744-5236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 MALL RD.",
            "address_2": "LAHEY CLINIC",
            "city": "BURLINGTON",
            "state": "MA",
            "postal_code": "018050001",
            "telephone_number": "781-744-7000",
            "fax_number": "781-744-5236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIDE",
        "first_name": "RUSSELL",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-19",
        "last_updated": "2013-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "153035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110059914A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, MA

Sources for this page

Verify at the official NPI Registry.