Individual provider Active NPI

Marybeth Ferrante, MD

  • Internal Medicine Physician
  • Cambridge, MA
National Provider Identifier
1194795781
Registry record updated Apr 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
80493 Issued in MA
Practice address
625 Mount Auburn St
Ste 104
Cambridge, MA 02138-4555
Phone
(617) 491-5586
Fax
(617) 661-5995
NPI assigned
Jan 25, 2006
Last updated
Apr 13, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 80493 MA Primary

Addresses

Primary practice location

625 Mount Auburn St
Ste 104
Cambridge, MA 02138-4555

Mailing address

625 Mount Auburn St
Ste 104
Cambridge, MA 02138-4555
Phone (617) 491-5586

Other identifiers 1

IdentifierTypeStateIssuer
3180395MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
80493MAMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334275200000",
    "number": "1194795781",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 MOUNT AUBURN ST",
            "address_2": "STE 104",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384555",
            "telephone_number": "617-491-5586",
            "fax_number": "617-661-5995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 MOUNT AUBURN ST",
            "address_2": "STE 104",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021384555",
            "telephone_number": "617-491-5586",
            "fax_number": "617-661-5995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FERRANTE",
        "first_name": "MARYBETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-25",
        "last_updated": "2012-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "80493",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3180395",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2012; 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.