Individual provider Active NPI

Maureen Ryan Dziura, MD

  • Pulmonary Disease Physician
  • Boston, MA
National Provider Identifier
1174818363
Registry record updated Jan 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
257510 Issued in MA
Practice address
800 Washington St
#369
Boston, MA 02111-1552
Phone
(617) 636-5000
NPI assigned
Jun 15, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 257510 MA Primary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 257510 MA
Internal Medicine Physician 207R00000X 257510 MA

Addresses

Primary practice location

800 Washington St
#369
Boston, MA 02111-1552

Mailing address

800 Washington St
# 369
Boston, MA 02111-1552

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20170711000038 MA Practitioner - Pulmonary DiseasePractitioner - Internal Medicine 4587884069 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Pulmonary DiseaseAlso: Internal Medicine
Education
Jefferson Medical College of Thomas Jefferson University, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
LGH Medical Group, Inc.Group PAC ID 3173626751, 165 clinicians
Pratt Medical Group IncGroup PAC ID 3375515661, 282 clinicians

Practice addresses (Care Compare)

295 Varnum Ave
Lowell, MA 01854-2134
Phone (978) 788-7344

800 Washington St
Boston, MA 02111-1552
Phone (617) 636-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
257510MAMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pratt Medical Group, Inc Pulmonary Disease CurrentSince Jul 1, 2017 Accepting new patients
LGH Medical Group, Inc. CurrentSince Sep 4, 2018 Accepting new patients
Pratt Medical Group, Inc Internal Medicine Current Accepting new patients
LGH Professional Services LLC Internal Medicine Past Accepting new patients
The Lowell General Hospital Past Accepting new patients

Locations

800 Washington St
Boston, MA 02111
Phone (617) 636-4800

800 Washington St
#369
Boston, MA 02111
Phone (617) 636-6366

295 Varnum Ave
Lowell, MA 01854
Phone (978) 788-7344

585 Lebanon St
Melrose, MA 02176
Phone (781) 979-3026

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/d04f75c7-2a62-4686-b520-7bf0635f38f0/

Organizations & group practices 5

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 1

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": "1308096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452643200000",
    "number": "1174818363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "address_2": "# 369",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "address_2": "#369",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DZIURA",
        "first_name": "MAUREEN",
        "middle_name": "RYAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-15",
        "last_updated": "2016-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "MA",
            "license": "257510",
            "primary": true
        },
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "MA",
            "license": "257510",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "257510",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.