SPORTS MEDICINE NORTH ORTHOPAEDIC SURGERY, INC (NPI# 1740793561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740793561 |
| Entity Type | Organization |
| Organization Name | SPORTS MEDICINE NORTH ORTHOPAEDIC SURGERY, INC |
| Practice Address |
1 Orthopedics Dr Peabody MA 01960-1668 |
| Practice Telephone | 9788186350 |
| Practice Fax Number | 9788186355 |
| Mailing Telephone | 9788186350 |
| Mailing Fax Number | 9788186355 |
| Enumeration Date | 2017-11-15 |
| Last Update Date | 2017-11-15 |
| Authorized Official Name | JEFFREY A. POLANSKY (PRESIDENT) |
| Authorized Official Telephone | 9788186350 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 110072100A | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376991505 | Sports Medicine North Orthopaedic Surgery, Inc | Physical Therapist | 112 Parker St, Newburyport, MA 01950-4008 | 2016-05-27 |
| 1689956831 | Sports Medicine North Orthopaedic Surgery, Inc | Specialist | 1 Blackburn Dr, Suite 5, Gloucester, MA 01930-2237 | 2011-09-14 |
| 1053693200 | Sports Medicine North Orthopaedic Surgery, Inc | Specialist | 147 S Main St, Middleton, MA 01949-2446 | 2011-09-14 |
| 1033400023 | Sports Medicine North Orthopaedic Surgery, Inc | Specialist | 1 Orthopedics Dr, 2nd Floor, Peabody, MA 01960-1668 | 2011-04-25 |
| Street Address |
1 ORTHOPEDICS DR |
| City | PEABODY |
| State | MA |
| Zip Code | 01960-1668 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104804673 | Jarett S Landman | Physician Assistant | 1 Orthopedics Dr, Peabody, MA 01960-1668 | 2006-01-05 |
| 1285101329 | Jordan M Evans | Physician Assistant | 1 Orthopedics Dr, Peabody, MA 01960-1668 | 2018-10-26 |
| 1821535378 | North Shore Ambulatory Anesthesia Partners LLC | Anesthesiology | 1 Orthopedics Dr, Peabody, MA 01960-1668 | 2017-01-23 |
| 1265983761 | Sports Medicine North Orthopedic Surgery, Inc. | Orthopaedic Surgery | 1 Orthopedics Dr, 2nd Floor, Peabody, MA 01960-1668 | 2016-10-19 |
| 1548653801 | Edward O'reilly | Physician Assistant | 1 Orthopedics Dr, 2nd Floor, Peabody, MA 01960-1668 | 2015-03-11 |
| 1699171470 | Sports Medicine North Orthopaedic Surgery, Inc. | Specialist | 1 Orthopedics Dr, Peabody, MA 01960-1668 | 2014-11-06 |
| 1528468121 | Kyle Williams | Physician Assistant | 1 Orthopedics Dr, Peabody, MA 01960-1668 | 2014-09-02 |
| 1912315722 | Allison Shawcross | Physical Therapist | 1 Orthopedics Dr, Peabody, MA 01960-1668 | 2014-07-24 |
| 1871910364 | Michelle J Bouley | Physician Assistant | 1 Orthopedics Dr, 2nd Floor, Peabody, MA 01960-1668 | 2014-03-24 |
| 1952742975 | Jared Polansky | Physician Assistant | 1 Orthopedics Dr, 2nd Floor, Peabody, MA 01960-1668 | 2013-07-08 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962020321 | Kathleen Marie Cliffe | Nurse Practitioner | 15 Sandra Rd, Peabody, MA 01960 | 2020-07-10 |
| 1801398102 | Janis Melanson | Counselor | Higgins Middle School, 85 Perkins Street, Peabody, MA 01960 | 2018-03-02 |
| 1679082036 | Kelsey Ann Lima | Social Worker | 9 Centennial Drive, Suite 202, Peabody, MA 01960 | 2017-09-28 |
| 1609394485 | Victoria Jade Olechowski | Specialist/Technologist | 1002 Crane Brook Way, Peabody, MA 01960 | 2017-08-31 |
| 1841715711 | Alexandra Lee Chasse | Counselor | 9 Cenntenial Drive, Suit 202, Peabody, MA 01960 | 2017-08-11 |
| 1275982936 | Miguel A Roque | Dentist | 6 Essex Center Drive Suite 110, Peabody, MA 01960 | 2016-06-03 |
| 1528412061 | Kabamedicalcorporation | Durable Medical Equipment & Medical Supplies | 484lowell Street, Peabody, MA 01960 | 2016-04-21 |
| 1437510815 | Ana Tereza T. Wescott | Dentist | 89 Foster Street, Peabody Family Health Center, Peabody, MA 01960 | 2016-03-14 |
| 1225496474 | Ashley Motta | Counselor | 24 Jennifer Lane, Peabody, MA 01960 | 2016-02-03 |
| 1578942645 | Cerebral Palsy of Eastern Mass Incorporated | Early Intervention Provider Agency | 6 Stratis Way, Peabody, MA 01960 | 2015-05-22 |
| Find all providers in zip 01960 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710964572 | Mri Radiologists of The N Shore Inc | Radiology | 68 Prospect St, Peabody, MA 01960-1605 | 2005-12-22 |
| 1316930423 | Andrew Polony | Radiology | 10 Dearborn Rd, Peabody, MA 01960-8836 | 2005-08-24 |
| 1154410587 | Janet Hope Sherman | Radiology | 1 Orthopedic Dr, Peabody, MA 01960-1668 | 2006-10-12 |
| 1124032271 | Stephen Howard Karshbaum | Radiology | 1 Orthopedic Dr, Peabody, MA 01960-1668 | 2006-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821604570 | Yarab Mubarak Habib Al Bulushi | Radiology | 330 Brookline Ave Dept of Radiology, Boston, MA 02215-5400 | 2020-09-18 |
| 1619595105 | Natasha Larocque | Radiology | 330 Brookline Avenue, Sherman 231, Beth Israel Deacones, Radiology Education Office, Boston, MA 02215 | 2020-07-10 |
| 1417507740 | Daniel Andres Vargas Zapata | Radiology | 330 Brookline Ave # Es-215, Boston, MA 02215-5491 | 2019-09-18 |
| 1386129468 | Keri Susan Bouthiller | Radiology | 9 Stevens St, Stoneham, MA 02180-1806 | 2018-09-25 |
| 1851870992 | Robert Kevin Moreland | Radiology | 75 Francis Street, Brigham and Women's Hospital, Boston, MA 02120 | 2018-08-09 |
| 1790270239 | Rahul Gujrathi | Radiology | 450 Brookline Ave Dana-farber Cancer Institute, Department of Imaging Dl-198, Boston, MA 02215 | 2018-06-27 |
| 1083104434 | Edgar Leonardo Martinez-salazar | Radiology | 20 Michigan Ave, Somerville, MA 02145-2228 | 2018-05-11 |
| 1548758790 | Hudson Valley Radiologists, PC | Radiology | 18 West Rd, Great Barrington, MA 01230-1947 | 2018-04-24 |
| 1700381282 | Casey Keith Bishop | Radiology | 820 Harrison Ave Dept Of, Boston, MA 02118-2905 | 2018-03-27 |
| 1922517713 | Arwa Alzaghal | Radiology | Department of Radiology, Brigham & Women's Hospital, 75 Francis Street, Boston, MA 02115 | 2017-09-25 |
| Find all providers with the same taxonomy | ||||
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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.