Individual provider Active NPI

Caitlin E Mahoney, NP-C

  • Nurse Practitioner
  • Boston, MA
National Provider Identifier
1295252047
Registry record updated May 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
RN2308185 Issued in MA
Practice address
330 Brookline Ave Ste Scg063
Boston, MA 02215-5491
Phone
(617) 632-7500
Fax
(617) 632-7522
NPI assigned
Aug 23, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X RN2308185 MA Primary

Addresses

Primary practice location

330 Brookline Ave Ste Scg063
Boston, MA 02215-5491

Mailing address

41 Lincoln Rd
Tewksbury, MA 01876-3678
Phone (978) 204-5928

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
I20180129001440 MA Practitioner - Nurse Practitioner 6901166651 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Practitioner, Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince May 12, 2021 Accepting new patients
The General Hospital Corporation CurrentSince Jun 26, 2019 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince May 12, 2021 Accepting new patients
Massachusetts General Physicians Organization Inc CurrentSince Jun 26, 2019 Accepting new patients
Boston Medical Center Corporation Current Accepting new patients

Locations

15 Parkman St
#230
Boston, MA 02114
Phone (617) 726-2740

330 Brookline Ave
Ste SCG63
Boston, MA 02215
Phone (617) 632-7500

55 Fruit St
Boston, MA 02114

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

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

Interoperability endpoints

  • Direct secure messaging: cmahoney86624@direct.bmc.masshiway.net

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.

NPI Registry JSON

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

{
    "created_epoch": "1503446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620259200000",
    "number": "1295252047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 LINCOLN RD",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018763678",
            "telephone_number": "978-204-5928",
            "fax_number": "978-851-0395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE STE SCG063",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022155491",
            "telephone_number": "617-632-7500",
            "fax_number": "617-632-7522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "CAITLIN",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-23",
        "last_updated": "2021-05-06",
        "certification_date": "2021-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "RN2308185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.