Individual provider Active NPI

Mona D Roberts, D.O.

  • Pediatrics Physician
  • Boston, MA
National Provider Identifier
1245573765
Registry record updated Apr 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
266911 Issued in MA
Practice address
801 Massachusetts Ave.
Crosstown BLDG FL 7
Boston, MA 02118
Phone
(617) 414-4841
Fax
(617) 414-4541
NPI assigned
Apr 3, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 266911 MA Primary

Addresses

Primary practice location

801 Massachusetts Ave.
Crosstown BLDG FL 7
Boston, MA 02118

Mailing address

BMC Provider Enrollment Office
960 Massachusetts Ave,.2ND Floor
Boston, MA 02118
Phone (617) 414-5405

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
I20160928001079 MA Practitioner - Pediatric Medicine 2769784362 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Child Health Foundation of Boston, Inc. Pediatrics CurrentSince Sep 15, 2016 Accepting new patients
Boston Medical Center Corporation Current Accepting new patients
Boston University Obstetrics and Gynecology Foundation, Inc. PastSince Sep 15, 2016 Accepting new patients

Locations

960 Massachusetts Ave
Ste 2
Boston, MA 02118

850 Harrison Ave
#6
Boston, MA 02118
Phone (617) 414-4841

850 Harrison Ave
#4
Boston, MA 02118
Phone (617) 414-2000

720 Harrison Ave
#503
Roxbury, MA 02118
Phone 6174145404 ext. 2

Interoperability endpoints

  • Direct secure messaging: mdoss96212@direct.bmc.masshiway.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1364947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712188800000",
    "number": "1245573765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BMC PROVIDER ENROLLMENT OFFICE",
            "address_2": "960 MASSACHUSETTS AVE,.2ND FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-414-5405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MASSACHUSETTS AVE.",
            "address_2": "CROSSTOWN BLDG FL 7",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-414-4841",
            "fax_number": "617-414-4541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MONA",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-03",
        "last_updated": "2024-04-04",
        "certification_date": "2024-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "266911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.