Marc S McDermott, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

5223923-1205 Issued in UT

Practice address

77 Hospital Avenue, Suite 302
Ambulatory Care Center
North Adams, MA 01247-2538

Phone

(413) 663-8365

Fax

(413) 662-2363

NPI assigned

Jul 3, 2006

Last updated

Nov 9, 2011By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mmcdermott14015@direct.chppoc.masshiway.net

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.

• Northern Berkshire Pediatrics, LLP

  • Pediatrics Physician
  • North Adams, MA
  • NPI 1750596201
  NPD (past)
• Department of Pediatrics University of Utah

  • Pediatrics Physician
  • Salt Lake City, UT
  • NPI 1679528715
  NPD (past)

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320796800000",
    "number": "1164452637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 HOSPITAL AVENUE, SUITE 302",
            "address_2": "AMBULATORY CARE CENTER",
            "city": "NORTH ADAMS",
            "state": "MA",
            "postal_code": "012472538",
            "telephone_number": "413-663-8365",
            "fax_number": "413-662-2363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 HOSPITAL AVENUE, SUITE 302",
            "address_2": "AMBULATORY CARE CENTER",
            "city": "NORTH ADAMS",
            "state": "MA",
            "postal_code": "012472538",
            "telephone_number": "413-663-8365",
            "fax_number": "413-662-2363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDERMOTT",
        "first_name": "MARC",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-03",
        "last_updated": "2011-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "5223923-1205",
            "primary": true
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "UT",
            "license": "5223923-1205",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "121348200",
            "state": "WY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100503184",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D5339",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "806860000",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0142817",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Peter D May, DO
• Christeen L McArdle, PA
• Lora Lyn McGrath, PT
• Makenzie Jean McNeice
• Donald H. Mead, D.D.S.
• Jessica Melendez, MS
• Messenger Digital Dentistry PC

• Pediatrics Physician in North Adams, MA
• Providers in North Adams, MA by specialty
• Pediatrics Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2011; 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.