Individual provider Active NPI

Allison Hickey Mariani, M.D.

  • Pediatrics Physician
  • Minneapolis, MN
National Provider Identifier
1255673075
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
70473 Issued in MN
Practice address
2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone
(612) 863-4000
Fax
(763) 236-3026
NPI assigned
Mar 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 270327 MA
Pediatrics Physician 208000000X 036.139944 IL
Student in an Organized Health Care Education/Training Program 390200000X
Pediatrics Physician 208000000X 70473 MN Primary

Addresses

Primary practice location

2925 Chicago Ave
Minneapolis, MN 55407-1321

Mailing address

2925 Chicago Ave
Minneapolis, MN 55407-1321
Phone (612) 863-4000

Other practice location 1

225 E Chicago Ave
Chicago, IL 60611
Phone (312) 227-4000

Other practice location 2

680 Centre St
Brockton, MA 02302-3308
Phone (508) 941-7580

Other names 1

  • Allison Talbert Hickey Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, MN2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20170712002447 MA Practitioner - Pediatric Medicine 4486923182 Reassigns benefits to 4 organizations
I20220822002524 MN Practitioner - Pediatric Medicine 4486923182 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
036.139944ILMDPediatrics Physician
70473MNMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Childrens Health Care CurrentSince Jul 25, 2022 Accepting new patients
Mass General Brigham Medical Group Suburban Massachusetts Inc CurrentSince Aug 24, 2019 Accepting new patients
The General Hospital Corporation CurrentSince Sep 1, 2018 Accepting new patients
Pratt Pediatric Associates Inc Pediatrics CurrentSince Jul 1, 2017 Accepting new patients
Massachusetts General Physicians Organization Inc Pediatrics CurrentSince Sep 1, 2018 Accepting new patients
Childrens Health Care Pediatrics CurrentSince Jul 25, 2022 Accepting new patients

Locations

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

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

2014 Washington St
Newtonville, MA 02462
Phone (617) 243-6000

2525 Chicago Ave
Minneapolis, MN 55404
Phone (612) 813-6000

347 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000

345 Smith Ave N
Saint Paul, MN 55102
Phone (651) 220-6000

Organizations & group practices 6

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": "1363651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1255673075",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-863-4000",
            "fax_number": "763-236-3026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2925 CHICAGO AVE",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554071321",
            "telephone_number": "612-863-4000",
            "fax_number": "763-236-3026"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "225 E Chicago Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "60611",
            "country_code": "US",
            "telephone_number": "312-227-4000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "680 Centre St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023023308",
            "country_code": "US",
            "telephone_number": "508-941-7580",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MARIANI",
        "first_name": "ALLISON",
        "middle_name": "HICKEY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-19",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "270327",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IL",
            "license": "036.139944",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MN",
            "license": "70473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALLISON",
            "last_name": "HICKEY",
            "middle_name": "TALBERT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Minneapolis, MN

Sources for this page

Verify at the official NPI Registry.