Individual provider Active NPI

Mallory N Lesieur, M.D.

  • Pulmonary Disease Physician
  • Boston, MA
National Provider Identifier
1154784510
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
288044 Issued in MA
Practice address
72 East Concord Street
R304
Boston, MA 02118-2690
Phone
(617) 358-1340
Fax
(617) 358-1337
NPI assigned
Apr 3, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 288044 MA
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 288044 MA
Pulmonary Disease Physician 207RP1001X 288044 MA Primary

Addresses

Primary practice location

72 East Concord Street
R304
Boston, MA 02118-2690

Mailing address

960 Massachusetts Ave
FL 2
Boston, MA 02118-2690

Other practice location 1

50 N Medical Dr
Salt Lake City, UT 84132-0001
Phone (801) 581-2121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231016000581 ME Practitioner - Pulmonary DiseasePractitioner - Critical Care (Intensivists) 1557627072 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Critical Care (Intensivists)
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Maine Medical CenterGroup PAC ID 2567379563, 344 clinicians

Practice addresses (Care Compare)

300 Main St
Lewiston, ME 04240-7027
Phone (207) 753-3900

76 High St
Suite 300
Lewiston, ME 04240-7591
Phone (207) 795-2729

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.02 of 100Reported as group
Quality
59.99
Promoting interoperability
99
Improvement activities
40
Cost
74.25

Merit-based Incentive Payment System (MIPS)

Final score
84.57 of 100Reported as group
Quality
66.56
Promoting interoperability
99
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
288044MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rumford Hospital CurrentSince Sep 1, 2024 Accepting new patients
Bridgton Hospital CurrentSince Sep 1, 2024 Accepting new patients
Rumford Hospital CurrentSince Sep 1, 2024 Accepting new patients
Central Maine Medical Center Current Accepting new patients
Central Maine Medical Center CurrentSince Sep 25, 2023 Accepting new patients
Central Maine Medical Center CurrentSince Sep 25, 2023 Accepting new patients
Bridgton Hospital CurrentSince Sep 1, 2024 Accepting new patients

Locations

10 Hospital Dr
Bridgton, ME 04009
Phone (207) 647-6000

300 Main St
Lewiston, ME 04240
Phone (207) 795-2400

76 High St
Ste 300
Lewiston, ME 04240
Phone (207) 795-5374

420 Franklin St
Rumford, ME 04276
Phone (207) 364-4581

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/4517c430-03bf-4e32-b324-1387cc4e73f3/

Organizations & group practices 7

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1459641600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1154784510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 MASSACHUSETTS AVE",
            "address_2": "FL 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690",
            "fax_number": "801-581-5393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 EAST CONCORD STREET",
            "address_2": "R304",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021182690",
            "telephone_number": "617-358-1340",
            "fax_number": "617-358-1337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "50 N Medical Dr",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841320001",
            "country_code": "US",
            "telephone_number": "801-581-2121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LESIEUR",
        "first_name": "MALLORY",
        "middle_name": "N",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-04-03",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "288044",
            "primary": false
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MA",
            "license": "288044",
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MA",
            "license": "288044",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.