Individual provider Active NPI

Mary Kendall Rago, MD

  • Otolaryngology Physician
  • Sewickley, PA
National Provider Identifier
1033182142
Registry record updated Dec 16, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD427007 Issued in PA
Practice address
301 Ohio River Blvd
Suite 202
Sewickley, PA 15143-1300
Phone
(412) 741-2122
Fax
(412) 741-5417
NPI assigned
Feb 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 35087146 OH
Otolaryngology Physician 207Y00000X 22164 WV
Otolaryngology Physician 207Y00000X MD427007 PA Primary

Addresses

Primary practice location

301 Ohio River Blvd
Suite 202
Sewickley, PA 15143-1300

Mailing address

301 Ohio River Blvd
Suite 202
Sewickley, PA 15143-1300
Phone (412) 741-2122

Other identifiers 4

IdentifierTypeStateIssuer
P00289437OtherOHRR MEDICARE
1018523020001MedicaidPA
3810004695MedicaidWV
2634706MedicaidOH

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL mrago@bforent.medentdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35087146OHMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Riverside Medical Inc. Past Accepting new patients
Riverside Medical Inc Otolaryngology Past Accepting new patients
Associated Hearing Aid Services,LP Past Accepting new patients

Organizations & group practices 3

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": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608076800000",
    "number": "1033182142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 OHIO RIVER BLVD",
            "address_2": "SUITE 202",
            "city": "SEWICKLEY",
            "state": "PA",
            "postal_code": "151431300",
            "telephone_number": "412-741-2122",
            "fax_number": "412-741-5417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 OHIO RIVER BLVD",
            "address_2": "SUITE 202",
            "city": "SEWICKLEY",
            "state": "PA",
            "postal_code": "151431300",
            "telephone_number": "412-741-2122",
            "fax_number": "412-741-5417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAGO",
        "first_name": "MARY",
        "middle_name": "KENDALL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2020-12-16",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "OH",
            "license": "35087146",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WV",
            "license": "22164",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "MD427007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00289437",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1018523020001",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3810004695",
            "state": "WV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2634706",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "mrago@bforent.medentdirect.com",
            "affiliation": "N",
            "address_1": "301 Ohio River Blvd",
            "address_2": "Suite 202",
            "city": "Sewickley",
            "state": "PA",
            "country_code": "US",
            "postal_code": "151431300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Sewickley, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.