NPIMap

Organization Active NPI

Urology Central PC

  • Urology Physician
  • Leominster, MA
National Provider Identifier
1942373691
Registry record updated Aug 11, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
212873 Issued in MA
Legal business name
UROLOGY CENTRAL PC
Practice address
50 Memorial Drive
Suite 108
Leominster, MA 01453
Phone
(978) 466-2280
Fax
(978) 466-2282
NPI assigned
Nov 17, 2006
Last updated
Aug 11, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2018

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

Authorized official

Name
Ronald G Ebb, MDNPI 1851333546
Title
Owner Physician
Phone
(978) 466-2280

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 212873 MA Primary

Addresses

Primary practice location

50 Memorial Drive
Suite 108
Leominster, MA 01453

Mailing address

50 Memorial Drive
Suite 108
Leominster, MA 01453
Phone (978) 466-2280

Other identifiers 4

IdentifierTypeStateIssuer
2110717MedicaidMA
637642OtherGRP TUFTS
M19406OtherBLUE CROSS GRP
0002695OtherGRP MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071013000061 MA Part B Supplier - Clinic/Group Practice 5294821765 Receives reassigned benefits from 1 practitioner
Practice locations: Leominster, MA

National Provider Directory

National Provider Directory
Tax ID family
Urology Central2 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.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533945600000",
    "number": "1942373691",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 MEMORIAL DRIVE",
            "address_2": "SUITE 108",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "01453",
            "telephone_number": "978-466-2280",
            "fax_number": "978-466-2282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 MEMORIAL DRIVE",
            "address_2": "SUITE 108",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "01453",
            "telephone_number": "978-466-2280",
            "fax_number": "978-466-2282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UROLOGY CENTRAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-17",
        "last_updated": "2018-08-11",
        "status": "A",
        "authorized_official_last_name": "EBB",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "978-466-2280",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "MA",
            "license": "212873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2110717",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GRP TUFTS",
            "identifier": "637642",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS GRP",
            "identifier": "M19406",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GRP MEDICARE",
            "identifier": "0002695",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leominster, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2018; 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.