NPIMap

Organization Active NPI

North Shore Radiological Associates, Inc.

  • Diagnostic Radiology Physician
  • Woburn, MA
National Provider Identifier
1932164522
Registry record updated Sep 2, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
Legal business name
NORTH SHORE RADIOLOGICAL ASSOCIATES, INC.
Practice address
200 Unicorn Park Drive
Suite 402
Woburn, MA 01801
Phone
(603) 943-5580
Fax
(603) 717-7445
NPI assigned
Apr 18, 2006
Last updated
Sep 2, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2016

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

Authorized official

Name
Suzanne J Matthews
Title
Business Manager
Phone
(800) 208-7069

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU Primary

Addresses

Primary practice location

200 Unicorn Park Drive
Suite 402
Woburn, MA 01801

Mailing address

PO Box 6750
Payment Remittace, Correspondence and Credentialing
Portsmouth, NH 03802-6750
Phone (800) 208-7069

Other identifiers 1

IdentifierTypeStateIssuer
9714847MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041207000430 MA Part B Supplier - Clinic/Group Practice 1153387675 Receives reassigned benefits from 23 practitioners
Practice locations: Reading, MA; Woburn, MA; Winchester, MA; Wilmington, MA; Stoneham, MA; Lynnfield, MA; Lexington, MA; Boston, MA

National Provider Directory

National Provider Directory
Tax ID family
North Shore Radiological ASC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

1350 Market St
Fl 2
Lynnfield, MA 01940
Phone (781) 213-4040

20 Pondmeadow Dr
Ste 106
Reading, MA 01867
Phone (781) 944-1166

3 Woodland Rd
Ste 300
Stoneham, MA 02180
Phone (339) 293-6020

38 Montvale Ave
Stoneham, MA 02180
Phone (781) 279-2158

200 Unicorn Park Dr
Ste 402
Woburn, MA 01801
Phone (603) 943-5580

Practitioners & affiliated clinicians

Practitioners 26

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.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472774400000",
    "number": "1932164522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 6750",
            "address_2": "PAYMENT REMITTACE, CORRESPONDENCE AND CREDENTIALING",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038026750",
            "telephone_number": "800-208-7069",
            "fax_number": "610-956-0009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 UNICORN PARK DRIVE",
            "address_2": "SUITE 402",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "01801",
            "telephone_number": "603-943-5580",
            "fax_number": "603-717-7445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH SHORE RADIOLOGICAL ASSOCIATES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-18",
        "last_updated": "2016-09-02",
        "status": "A",
        "authorized_official_last_name": "MATTHEWS",
        "authorized_official_first_name": "SUZANNE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "800-208-7069"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9714847",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; 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.