Randolph D. Maloney, M.D., PC

Primary specialty

Physiological LaboratoryTaxonomy code 293D00000X

License

35297 Issued in MA

Legal business name

RANDOLPH D. MALONEY, M.D., PC

Practice address

75 Herrick St
Suite 110 - Parkhurst Medical BLDG.
Beverly, MA 01915-5900

Phone

(978) 922-5535

Fax

(978) 922-5667

NPI assigned

Aug 5, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Randolph David Maloney, M.D.

Title

Medical Director President

Phone

(978) 922-5535

Specialties & licenses 2

Addresses

Other identifiers 6

Other names 1

• North Shore Vascular Diagnostic Laboratory Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lindsay Welenc

  • Vascular Sonography Radiologic Technologist
  • Beverly, MA
  • NPI 1063964427
  NPD (past)

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1124037361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 HERRICK ST",
            "address_2": "SUITE 110 - PARKHURST MEDICAL BLDG.",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019155900",
            "telephone_number": "978-922-5535",
            "fax_number": "978-922-5667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 HERRICK ST",
            "address_2": "SUITE 110 - PARKHURST MEDICAL BLDG.",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019155900",
            "telephone_number": "978-922-5535",
            "fax_number": "978-922-5667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANDOLPH D. MALONEY, M.D., PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "MALONEY",
        "authorized_official_first_name": "RANDOLPH",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR PRESIDENT",
        "authorized_official_telephone_number": "978-922-5535",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2471V0105X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Radiologic Technologist, Vascular Sonography",
            "state": "MA",
            "license": "RDMS-RVT",
            "primary": false
        },
        {
            "code": "293D00000X",
            "taxonomy_group": "",
            "desc": "Physiological Laboratory",
            "state": "MA",
            "license": "35297",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS/BLUESHIELD",
            "identifier": "021569",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "801461",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9769706",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON HEALTH",
            "identifier": "33434",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "950000914",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HARVARD PILGRAM",
            "identifier": "606913",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North Shore Vascular Diagnostic Laboratory",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Francia Ramirez
• Anne-Marie Rance, OTR/L
• Alexandra Randall-Miller
• Stacy Randall, RN
• Keith Rando, LMHC
• Tanya Ranke
• Amanda Ranttila, OT
• Nicole Rapkowicz
• Joan Cecile Rapp, M. ED
• Vladimir Ratushny, M.D., PH.D.

• Physiological Laboratory in Beverly, MA
• Providers in Beverly, MA by specialty
• Physiological Laboratory in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.