Individual provider Active NPI

Nicole Mary Mahoney, PA-C

  • Physician Assistant
  • South Weymouth, MA
National Provider Identifier
1225325368
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA4190 Issued in MA
Practice address
780 Main St
South Weymouth, MA 02190-1622
Phone
(781) 331-4600
NPI assigned
Jul 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA4190 MA Primary

Addresses

Primary practice location

780 Main St
South Weymouth, MA 02190-1622

Mailing address

141 Longwater Dr
Norwell, MA 02061-1632
Phone (781) 681-0384

Other practice location 1

55 Fogg Rd
Weymouth, MA 02190-2432
Phone (781) 624-8000

Other practice location 2

101 Columbian St
Weymouth, MA 02190-1601
Phone (781) 624-5000

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120125000854 MA Practitioner - Physician Assistant 7315114774 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Shore Medical Center, Inc.Group PAC ID 3678487444, 174 clinicians
Coastal Medical AssociatesGroup PAC ID 7113029257, 443 clinicians

Practice addresses (Care Compare)

101 Columbian St
Weymouth, MA 02190-1601
Phone (781) 624-5000

5 Tarkiln Rd
Kingston, MA 02364-1250
Phone (781) 585-2200

55 Fogg Rd
Weymouth, MA 02190-2432
Phone (781) 624-8000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
72.58 of 100Reported as group
Quality
58.14
Promoting interoperability
74
Improvement activities
40
Cost
72.13

Merit-based Incentive Payment System (MIPS)

Final score
86.65 of 100Reported as group
Quality
88.12
Promoting interoperability
71
Improvement activities
40
Cost
77.69

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Consultants of Massachusetts, P.C. Physician Assistant Past Accepting new patients

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 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": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708905600000",
    "number": "1225325368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 LONGWATER DR",
            "city": "NORWELL",
            "state": "MA",
            "postal_code": "020611632",
            "telephone_number": "781-681-0384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "780 MAIN ST",
            "city": "SOUTH WEYMOUTH",
            "state": "MA",
            "postal_code": "021901622",
            "telephone_number": "781-331-4600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Fogg Rd",
            "address_purpose": "LOCATION",
            "city": "Weymouth",
            "state": "MA",
            "postal_code": "021902432",
            "country_code": "US",
            "telephone_number": "781-624-8000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "101 Columbian St",
            "address_purpose": "LOCATION",
            "city": "Weymouth",
            "state": "MA",
            "postal_code": "021901601",
            "country_code": "US",
            "telephone_number": "781-624-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "NICOLE",
        "middle_name": "MARY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-08",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA4190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Weymouth, MA

Sources for this page

Verify at the official NPI Registry.