NPIMap

Organization Active NPI

Moira L McDermott Lower Cape Podiatry

  • Podiatrist
  • Brewster, MA
National Provider Identifier
1013119544
Registry record updated Apr 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
Legal business name
MOIRA L MCDERMOTT LOWER CAPE PODIATRY
Practice address
4 Granite State CT
Brewster, MA 02631-2127
Phone
(508) 255-1100
NPI assigned
Jun 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2009

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

Authorized official

Name
Ms. Sheila Duffy
Title
Office Manager
Phone
(508) 255-1100

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PodiatristGroup: 193400000X SINGLE SPECIALTY GROUP 213E00000X Primary

Addresses

Primary practice location

4 Granite State CT
Brewster, MA 02631-2127

Mailing address

4 Granite State CT
Brewster, MA 02631-2127
Phone (508) 255-1100

Other identifiers 4

IdentifierTypeStateIssuer
729636OtherMATUFTS GROUP#
H670OtherMAHARVARD GROUP #
H679OtherMAHARVARD PILGRIM
Y77135OtherMABC GROUP#

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040412000327 MA Part B Supplier - Clinic/Group Practice 1658365903 Receives reassigned benefits from 4 practitioners
Practice locations: Brewster, MA

National Provider Directory

National Provider Directory

Locations

4 Granite State Ct
#6
Brewster, MA 02631

4 Granite State Ct
Brewster, MA 02631
Phone (508) 225-1100

4 Granite State Ct
#67
Brewster, MA 02631

Practitioners & affiliated clinicians

Practitioners 8

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": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239840000000",
    "number": "1013119544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 GRANITE STATE CT",
            "city": "BREWSTER",
            "state": "MA",
            "postal_code": "026312127",
            "telephone_number": "508-255-1100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 GRANITE STATE CT",
            "city": "BREWSTER",
            "state": "MA",
            "postal_code": "026312127",
            "telephone_number": "508-255-1100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOIRA L MCDERMOTT LOWER CAPE PODIATRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2009-04-16",
        "status": "A",
        "authorized_official_last_name": "DUFFY",
        "authorized_official_first_name": "SHEILA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "508-255-1100",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS GROUP#",
            "identifier": "729636",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD GROUP #",
            "identifier": "H670",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRIM",
            "identifier": "H679",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC GROUP#",
            "identifier": "Y77135",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewster, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2009; 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.