Individual provider Active NPI

Randolph James Nadir, PA-C

  • Physician Assistant
  • North Andover, MA
National Provider Identifier
1982374302
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9011 Issued in MA
Practice address
419B Andover St
North Andover, MA 01845-5001
Phone
(978) 620-5048
Fax
(978) 620-5073
NPI assigned
Sep 16, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA9011 MA Primary

Addresses

Primary practice location

419B Andover St
North Andover, MA 01845-5001

Mailing address

360 US Highway 1 Byp Unit 102
Portsmouth, NH 03801-7105
Phone (603) 410-6700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20221102001079 MA Practitioner - Physician Assistant 9032586110 Reassigns benefits to 3 organizations
I20230929002111 NH Practitioner - Physician Assistant 9032586110 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Convenientmd - FFS UC LLCGroup PAC ID 5193186492, 397 clinicians

Practice addresses (Care Compare)

1 Interchange Dr
Unit 2
West Lebanon, NH 03784-2011
Phone (603) 709-0410

1 Portsmouth Ave
Stratham, NH 03885-2585
Phone (603) 772-3600

1 Sharma Way
Windham, NH 03087-2008
Phone (603) 890-6330

2 Dobson Way
Merrimack, NH 03054-4340
Phone (603) 471-6069

3 Nashua Rd
Bedford, NH 03110-5515
Phone (603) 472-6700

40 Davis Straits
Falmouth, MA 02540-3906
Phone (774) 255-3010

49 Plaistow Rd
Plaistow, NH 03865-2854
Phone (603) 371-3229

551 Meadow St
Littleton, NH 03561-3615
Phone (603) 761-3660

599 Lafayette Rd
Portsmouth, NH 03801-5409
Phone (603) 942-7900

738 Hooksett Rd
Manchester, NH 03104-2617
Phone (603) 384-3900

8 Loudon Rd
Concord, NH 03301-5300
Phone (603) 226-9000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2060NHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lahey Clinic, Inc CurrentSince Oct 1, 2022 Accepting new patients
Convenientmd - FFS UC LLC CurrentSince Aug 4, 2023 Accepting new patients
Lahey Clinic, Inc. CurrentSince Oct 1, 2022 Accepting new patients
Convenientmd - FFS UC LLC CurrentSince Oct 2, 2023 Accepting new patients
Convenientmd - FFS UC LLC CurrentSince Aug 4, 2023 Accepting new patients
Convenientmd LLC Past Accepting new patients

Locations

245 Hartford Ave
Bellingham, MA 02019
Phone (774) 295-4355

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

40 Davis Straits
Falmouth, MA 02540
Phone (774) 255-3010

419 Andover St
#B
North Andover, MA 01845
Phone (978) 620-5040

3 Nashua Rd
Bedford, NH 03110
Phone (603) 472-6700

2 Dobson Way
Merrimack, NH 03054
Phone (603) 471-6069

360 US Highway 1 Byp
Unit 102
Portsmouth, NH 03801
Phone (603) 410-6700

111 New Hampshire Ave
Portsmouth, NH 03801

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1631750400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1982374302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 US HIGHWAY 1 BYP UNIT 102",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017105",
            "telephone_number": "603-410-6700",
            "fax_number": "603-319-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "419B ANDOVER ST",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018455001",
            "telephone_number": "978-620-5048",
            "fax_number": "978-620-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NADIR",
        "first_name": "RANDOLPH",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-09-16",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA9011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Andover, MA

Sources for this page

Verify at the official NPI Registry.