Active NPI
Molly Tracy, M.D.
- Neurology with Special Qualifications in Child Neurology Physician
- Boston, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology with Special Qualifications in Child Neurology Physician
- License
- 235420
- Practice address
- 300 Longwood Ave
Fegan 11
Boston, MA 02115-5724 - Phone
- (617) 355-6388
- NPI assigned
- Aug 15, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology with Special Qualifications in Child Neurology Physician | 2084N0402X | 235420 | MA | Primary |
| Neurology with Special Qualifications in Child Neurology Physician | 2084N0402X | MD13088 | RI |
Addresses
Primary practice location
300 Longwood Ave
Fegan 11
Boston, MA 02115-5724
Mailing address
300 Longwood Ave
Fegan 11
Boston, MA 02115-5724
Phone (617) 355-6388
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110084585A | Medicaid | MA |
Other names 1
- Dr. Molly Christianson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in RI, MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- University of Minnesota Medical School, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
300 Longwood Ave
Boston, MA 02115-5724
Phone (617) 355-6000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD13088 | RI | MD | Neurology with Special Qualifications in Child Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brown Neurology | Current | Accepting new patients | |
| Baystate Medical Practices, Inc | Current | Accepting new patients | |
| C H Neurology Foundation Inc | Neurology With Special Qualifications in Child Neurology | Current | Accepting new patients |
Locations
300 Longwood Ave
#11
Boston, MA 02115
Phone (617) 355-6388
300 Longwood Ave
Boston, MA 02115
Phone (617) 355-4956
759 Chestnut St
Springfield, MA 01199
Phone (413) 794-3233
50 Wason Ave
Springfield, MA 01107
Phone (413) 794-2515
593 Eddy St
Providence, RI 02903
Interoperability endpoints
- mtracy22381@direct.bostonchildrens.org
Organizations & group practices 3
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.
-
- Neurology with Special Qualifications in Child Neurology Physician
- Boston, MA
- NPI 1063432417
-
- Emergency Medical Services (Emergency Medicine) Physician
- Springfield, MA
- NPI 1548205909
-
- Neurology Physician
- Providence, RI
- NPI 1366486102
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1187136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491436800000",
"number": "1124210968",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 LONGWOOD AVE",
"address_2": "FEGAN 11",
"city": "BOSTON",
"state": "MA",
"postal_code": "021155724",
"telephone_number": "617-355-6388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 LONGWOOD AVE",
"address_2": "FEGAN 11",
"city": "BOSTON",
"state": "MA",
"postal_code": "021155724",
"telephone_number": "617-355-6388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRACY",
"first_name": "MOLLY",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-08-15",
"last_updated": "2017-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "2084N0402X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
"state": "MA",
"license": "235420",
"primary": true
},
{
"code": "2084N0402X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
"state": "RI",
"license": "MD13088",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110084585A",
"state": "MA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "MOLLY",
"last_name": "CHRISTIANSON",
"prefix": "DR.",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Boston, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.