Elizabeth Blake McGough

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DN1859380 Issued in MA

Practice address

761 Washington St
Norwood, MA 02062-6612

Phone

(781) 762-8855

NPI assigned

Apr 19, 2022

Last updated

Oct 30, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Endodontic Care PC

  • Endodontics
  • Norwood, MA
  • NPI 1609970904
  NPD (past)

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

{
    "created_epoch": "1650326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1053054916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "761 WASHINGTON ST",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020626612",
            "telephone_number": "781-762-8855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "761 WASHINGTON ST",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020626612",
            "telephone_number": "781-762-8855"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5 School St",
            "address_purpose": "LOCATION",
            "city": "Dedham",
            "state": "MA",
            "postal_code": "020264309",
            "country_code": "US",
            "telephone_number": "781-329-5930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCGOUGH",
        "first_name": "ELIZABETH",
        "middle_name": "BLAKE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-19",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1859380",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MA",
            "license": "DN1859380",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan McDermott, NP-C, FNP
• Isabella Rose McDonald, WHNP-BC
• Sharon Marie McDonough-Busa, LICSW
• Leah Nicholson McDonough, MSW
• Marybeth McDonough
• Megan Lorraine McGrath, MSW, LICSW
• Shannon McGrath
• Rachel Marie McHugh
• Alicia M McKersie, PAC
• Sherri McKittrick

• Endodontics in Norwood, MA
• Providers in Norwood, MA by specialty
• Endodontics in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.