Active NPI
Ellen Anne Mahony, M.D,
- Plastic Surgery Physician
- Westport, CT
National Provider Identifier
1063533750
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Plastic Surgery Physician
- License
- 035228
- Practice address
- 131 Kings Hwy N
Westport, CT 06880-2439 - Phone
- (203) 221-0102
- Fax
- (203) 221-1121
- NPI assigned
- Apr 2, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Plastic Surgery Physician | 208200000X | 035228 | CT | Primary |
Addresses
Primary practice location
131 Kings Hwy N
Westport, CT 06880-2439
Mailing address
22 Otter TRL
Westport, CT 06880-4919
Phone (203) 221-0102
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160510002027 | CT | Order and Referring Only - Plastic and Reconstructive Surgery | 6103115464 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 035228 | CT | MD | Plastic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1063533750",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22 OTTER TRL",
"city": "WESTPORT",
"state": "CT",
"postal_code": "068804919",
"telephone_number": "203-221-0102",
"fax_number": "203-221-1121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "131 KINGS HWY N",
"city": "WESTPORT",
"state": "CT",
"postal_code": "068802439",
"telephone_number": "203-221-0102",
"fax_number": "203-221-1121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAHONY",
"first_name": "ELLEN",
"middle_name": "ANNE",
"credential": "M.D,",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208200000X",
"taxonomy_group": "",
"desc": "Plastic Surgery",
"state": "CT",
"license": "035228",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westport, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.