BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. (NPI# 1043710791) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043710791 |
| Entity Type | Organization |
| Organization Name | BETH ISRAEL LAHEY HEALTH PRIMARY CARE, INC. |
| Other Organization Name | LAHEY PHYSICIAN COMMUNITY ORGANIZATION I INC |
| Practice Address |
Lahey Institute of Urology, Beverly 41 Mall Rd. Burlington MA 01805 |
| Mailing Address |
41 Mall Rd Burlington MA 01805-0001 |
| Practice Telephone | 9789270714 |
| Practice Fax Number | 9789279135 |
| Mailing Telephone | 7817448085 |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2019-12-23 |
| Authorized Official Name | DAVID L LONGWORTH (CEO) |
| Authorized Official Telephone | 7817448097 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | BETH ISRAEL LAHEY HEALTH INC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 110115155A | 05 |
| Other Name | Type Code |
|---|---|
| Lahey Physician Community Organization I INC | Former Legal Business Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922505072 | Beth Israel Lahey Health Primary Care, Inc. | Clinic/Center | 1350 Market Street, 2nd Floor, Beth Israel Lahey Health Primary Care, Inc., Lynnfield, MA 01940 | 2018-04-06 |
| 1174042337 | Beth Israel Lahey Health Primary Care, Inc. | Internal Medicine | Lahey Health Primary Care, North Andover, 170 Pleasant St., N. Andover, MA 01845 | 2017-09-19 |
| 1609396803 | Beth Israel Lahey Health Primary Care, Inc. | Clinic/Center | Lahey Health Urgent Care Gloucester, 298 Washington St., Gloucester, MA 01930 | 2017-06-20 |
| 1316479660 | Beth Israel Lahey Health Primary Care, Inc. | Clinic/Center | 480 Maple St., Lahey Health Urgent Care, Danvers, Danvers, MA 01923 | 2017-03-28 |
| 1366983322 | Beth Israel Lahey Health Primary Care, Inc. | Urology | Lahey Physician Community I Inc, 41 Mall Rd., Burlington, MA 01805-0001 | 2017-03-10 |
| 1063873842 | Beth Israel Lahey Health Primary Care, Inc. | Internal Medicine | 2284 Main Street, Lahey Health Primary Care, Concord, Concord, MA 01742 | 2016-03-08 |
| 1508244195 | Beth Israel Lahey Health Primary Care, Inc. | Internal Medicine | Beverly 75 Herrick St, Lahey Institute of Urology, Beverly, MA 01915 | 2015-05-14 |
| 1528556529 | Beth Israel Lahey Health Primary Care, Inc. | Family Medicine | Lahey Health Primary Care, Lynnfield, 1350 Market Street, 2nd Floor, Lynnfield, MA 01940 | 2018-04-25 |
| Street Address |
LAHEY INSTITUTE OF UROLOGY, BEVERLY 41 MALL RD. |
| City | BURLINGTON |
| State | MA |
| Zip Code | 01805 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750867909 | Natalie Teresa Dal'bo | Student in an Organized Health Care Education/Training Program | 41 Mall Road Office of Graduate Medical Education, Burlington, MA 01805 | 2018-07-11 |
| 1902240872 | Lloyd Jones Jr. | Student in an Organized Health Care Education/Training Program | 41 Mall Rd Department of Plastic Surgery, Burlington, MA 01805 | 2013-04-23 |
| 1508020470 | Russell Andrew Baur | Internal Medicine | Lahey Clinic Inc., 41 Mall Road, Burlington, MA 01805 | 2008-07-10 |
| 1356491237 | Jacob Magee Sands | Internal Medicine | 41 Burlington Mall Rd., Lahey Clinic, Burlington, MA 01805 | 2007-01-11 |
| 1588757108 | Richard Alan Wold | Nurse Anesthetist, Certified Registered | Lahey Clinic Medical Center, 41 Mall Road, Burlington, MA 01805 | 2006-10-02 |
| 1841302387 | David M. Venesy | Internal Medicine | Lahey Clinic Cardiology -5 E, 41 Mall Road, Burlington, MA 01805 | 2006-08-31 |
| 1790750354 | Cara J. Foss | Nurse Practitioner | Lahey Hospital and Medical Center, 41 Mall Road, Burlington, MA 01805 | 2006-02-17 |
| 1750376380 | Darryl D Esakof | Internal Medicine | 41 Mall Road, Department of Cardiovascular Medicine, Lahey Clinic, Burlington, MA 01805 | 2005-09-20 |
| 1225022155 | Laura Saluja | Internal Medicine | Lahey Clinic - General Internal Medicine, 41 Mall Road, Burlington, MA 01805 | 2005-09-07 |
| 1770588923 | Gene Wong | Radiology | 41 Mall Rd, Burlington, MA 01805 | 2005-06-15 |
| Find all providers in zip 01805 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366983322 | Beth Israel Lahey Health Primary Care, Inc. | Urology | Lahey Physician Community I Inc, 41 Mall Rd., Burlington, MA 01805-0001 | 2017-03-10 |
| 1114293727 | Benjamin King | Urology | 111 Colchester Ave # Ep-5, Burlington, VT 05401-1473 | 2012-03-28 |
| 1760656078 | Jab Inc | Urology | 64 Colchester Avenue, Burlington, VT 05401-1417 | 2008-04-17 |
| 1619174612 | Brian Hilbert Irwin | Urology | 111 Colchester Ave. Acc/ Ep5, Fahc Urology, Burlington, VT 05401 | 2007-07-02 |
| 1902975428 | Michael Richard Wolff | Urology | 841 Heather Rd, Burlington, NC 27215-6288 | 2006-11-07 |
| 1205934247 | John A Bisson | Urology | 64 Colchester Ave, Burlington, VT 05401-1417 | 2006-09-21 |
| 1407831365 | Burlington Urology PC | Urology | 400 S Broadway St, Burlington, IA 52601 | 2005-12-13 |
| 1023011517 | Eric Richmond Sargent | Urology | 111 Colchester Avenue, East Pavilion 5, Burlington, VT 05401 | 2005-05-27 |
| 1457745903 | Curtis Howard Cleveland | Urology | 111 Colchester Ave, Burlington, VT 05401-1473 | 2015-03-23 |
| 1609264522 | Concord Specialists, LLC | Urology | 41 Mall Rd, Legal Dept., Burlington, MA 01805-0001 | 2014-12-30 |
| Find all providers in BURLINGTON | ||||
| City | BURLINGTON |
| Zip Code | 01805 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.