Nicola Mogavero MD Facr

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

81784 Issued in MA

Legal business name

NICOLA MOGAVERO MD FACR

Practice address

792 Main St
Melrose, MA 02176-2710

Phone

(781) 665-9066

Fax

(781) 662-9758

NPI assigned

Nov 4, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Nicola Mogavero, MD

Title

Owner

Phone

(781) 665-9066

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1446595200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1446595200000",
    "number": "1396118964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "792 MAIN ST",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "021762710",
            "telephone_number": "781-665-9066",
            "fax_number": "781-662-9758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "792 MAIN ST",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "021762710",
            "telephone_number": "781-665-9066",
            "fax_number": "781-662-9758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOLA MOGAVERO MD FACR",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-04",
        "last_updated": "2015-11-04",
        "status": "A",
        "authorized_official_last_name": "MOGAVERO",
        "authorized_official_first_name": "NICOLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-665-9066",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MA",
            "license": "81784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110059518A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Melrose, MA
• Providers in Melrose, MA by specialty
• Clinic/Center in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.