Individual provider Active NPI

Margaret Mary Heffernan

  • Clinical Neuropsychologist
  • Boston, MA
National Provider Identifier
1114945482
Registry record updated May 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
6704 Issued in MA
Practice address
330 Brookline Ave
Behavioral Neurology Dept.
Boston, MA 02215-5400
Phone
(617) 667-1317
Fax
(617) 667-7981
NPI assigned
Jul 17, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 6704 MA Primary

Addresses

Primary practice location

330 Brookline Ave
Behavioral Neurology Dept.
Boston, MA 02215-5400

Mailing address

407 Rounseville Rd
Rochester, MA 02770-2009
Phone (617) 667-1317

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070503000651 MA Practitioner - Clinical Psychologist 7012013279 Practice locations: New Bedford, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Boston University School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

388 County St
New Bedford, MA 02740-4992
Phone (774) 762-0886

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
6704MAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Susan L. Perry, Licsw, P.C. PastSince Jul 1, 1990 Accepting new patients

Organizations & group practices 1

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1305849600000",
    "number": "1114945482",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "407 ROUNSEVILLE RD",
            "city": "ROCHESTER",
            "state": "MA",
            "postal_code": "027702009",
            "telephone_number": "617-667-1317",
            "fax_number": "617-667-7981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "address_2": "BEHAVIORAL NEUROLOGY DEPT.",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155400",
            "telephone_number": "617-667-1317",
            "fax_number": "617-667-7981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEFFERNAN",
        "first_name": "MARGARET",
        "middle_name": "MARY",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2011-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MA",
            "license": "6704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.