NPIMap

Individual provider Active NPI

Mary M Staffa, MD

  • Diagnostic Radiology Physician
  • Worcester, MA
National Provider Identifier
1356323646
Registry record updated Sep 14, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
70412 Issued in MA
Practice address
5 Neponset St
Worcester, MA 01606-2714
Phone
(508) 853-2716
Fax
(508) 854-0479
NPI assigned
Nov 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 70412 MA Primary

Addresses

Primary practice location

5 Neponset St
Worcester, MA 01606-2714

Mailing address

5 Neponset St FL Street12
Worcester, MA 01606-2714
Phone (508) 853-2716

Other identifiers 3

IdentifierTypeStateIssuer
732821OtherMATUFTS HEALTH PLAN
J10760OtherMABCBS MA
3076351MedicaidMA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040608000175 MA Practitioner - Diagnostic Radiology 9739162272 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Boston University School of Medicine, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Brigham and Womens Physicians Organization IncGroup PAC ID 3870405988, 2,931 clinicians

Practice addresses (Care Compare)

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

Hospital & facility affiliations

  • Brigham and Women Faulkner Hospital Hospital, Jamaica Plain, MA, CCN 220119
  • Dana-Farber Cancer Institute Hospital, Boston, MA, CCN 220162
  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham & Womens Physicians Organization Inc CurrentSince Feb 18, 2022 Accepting new patients
Mass General Brigham Medical Group Suburban Massachusetts Inc CurrentSince Jul 15, 2020 Accepting new patients
Harbor Medical Associates, Inc. CurrentSince Feb 18, 2022 Accepting new patients
Harbor Medical Associates, Inc. Diagnostic Radiology CurrentSince Feb 18, 2022 Accepting new patients
Newton Wellesley Hospital Current Accepting new patients
Reliant Medical Group, Inc Past Accepting new patients

Locations

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

75 Francis St
Boston, MA 02115

55 Fruit St
Boston, MA 02114

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

541 Main St
Ste 314
Weymouth, MA 02190
Phone (781) 952-1200

541 Main St
Ste 210
Weymouth, MA 02190
Phone (781) 952-1200

Interoperability endpoints

  • Direct secure messaging: staffa.mary.nwh@direct.partners.masshiway.net

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.

Hospital & facility affiliations 4

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": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536883200000",
    "number": "1356323646",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 NEPONSET ST FL STREET12",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062714",
            "telephone_number": "508-853-2716",
            "fax_number": "508-854-0479"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 NEPONSET ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016062714",
            "telephone_number": "508-853-2716",
            "fax_number": "508-854-0479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAFFA",
        "first_name": "MARY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-14",
        "last_updated": "2018-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "70412",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS HEALTH PLAN",
            "identifier": "732821",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MA",
            "identifier": "J10760",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3076351",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.