Individual provider Active NPI

Mary McGaugh, M.D.

  • Pediatrics Physician
  • Quincy, MA
National Provider Identifier
1124019765
Registry record updated Feb 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
75412 Issued in MA
Practice address
191 Independence Ave
Quincy, MA 02169-7751
Phone
(617) 773-5070
Fax
(617) 472-2380
NPI assigned
Nov 2, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 75412 MA Primary

Addresses

Primary practice location

191 Independence Ave
Quincy, MA 02169-7751

Mailing address

191 Independence Ave
Quincy, MA 02169-7751
Phone (617) 773-5070

Other identifiers 4

IdentifierTypeStateIssuer
075412OtherMATUFHTS HEALTH PLAN
3092887MedicaidMA
J12178OtherMABLUE SHIELD OF MA
20728OtherMAHPHC

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
75412MAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Quincy Pediatric Associates Inc Pediatrics Current Accepting new patients

Locations

769 Plain St
Ste F
Marshfield, MA 02050

191 Independence Ave
Quincy, MA 02169
Phone (617) 773-5070

Interoperability endpoints

  • Direct secure messaging: mcgaugh.mary.qui@direct.partners.masshiway.net

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": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361232000000",
    "number": "1124019765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "191 INDEPENDENCE AVE",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021697751",
            "telephone_number": "617-773-5070",
            "fax_number": "617-472-2380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "191 INDEPENDENCE AVE",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021697751",
            "telephone_number": "617-773-5070",
            "fax_number": "617-472-2380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGAUGH",
        "first_name": "MARY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2013-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "75412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFHTS HEALTH PLAN",
            "identifier": "075412",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3092887",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF MA",
            "identifier": "J12178",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HPHC",
            "identifier": "20728",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2013; 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.