NPIMap

Organization Active NPI

Northeast Allergy Asthma & Immunology, PC

  • Allergy & Immunology Physician
  • Leominster, MA
National Provider Identifier
1972835809
Registry record updated Jan 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Allergy & Immunology PhysicianTaxonomy code 207K00000X
Legal business name
NORTHEAST ALLERGY ASTHMA & IMMUNOLOGY, PC
Practice address
79 Erdman Way
Suite 101
Leominster, MA 01453
Phone
(978) 537-4805
Fax
(978) 537-2185
NPI assigned
Feb 3, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2016

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

Authorized official

Name
Dr. Jordan E. Scott, M.D.NPI 1275517245
Title
President/Physiciain
Phone
(978) 537-4805

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
Allergy & Immunology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207K00000X Primary

Addresses

Primary practice location

79 Erdman Way
Suite 101
Leominster, MA 01453

Mailing address

79 Erdman Way
Suite 101
Leominster, MA 01453
Phone (978) 537-4805

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100416000306 MA Part B Supplier - Clinic/Group Practice 2860529203 Receives reassigned benefits from 12 practitioners
2 other NPIs on this enrollment
Practice locations: Worcester, MA; Sudbury, MA; Leominster, MA; Concord, MA; Newton, MA

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

21 Eastern Ave
Ste 4
Worcester, MA 01605

21 Eastern Ave
Ste 31
Worcester, MA 01605

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1265155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452643200000",
    "number": "1972835809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "79 ERDMAN WAY",
            "address_2": "SUITE 101",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "01453",
            "telephone_number": "978-537-4805",
            "fax_number": "978-537-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 ERDMAN WAY",
            "address_2": "SUITE 101",
            "city": "LEOMINSTER",
            "state": "MA",
            "postal_code": "01453",
            "telephone_number": "978-537-4805",
            "fax_number": "978-537-2185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST ALLERGY ASTHMA & IMMUNOLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-03",
        "last_updated": "2016-01-13",
        "status": "A",
        "authorized_official_last_name": "SCOTT",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT/PHYSICIAIN",
        "authorized_official_telephone_number": "978-537-4805",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jan 13, 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.