Active NPI
Maureen W White, PA-C
- Surgical Physician Assistant
- Dorchester Center, MA
National Provider Identifier
1396839130
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgical Physician Assistant
- License
- 255
- Practice address
- 2100 Dorchester Ave
Dorchester Center, MA 02124-5615 - Phone
- (617) 296-4000
- NPI assigned
- Oct 3, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgical Physician Assistant | 363AS0400X | 255 | MA | Primary |
Addresses
Primary practice location
2100 Dorchester Ave
Dorchester Center, MA 02124-5615
Mailing address
166 Lake Shore Dr
Weymouth, MA 02189-1537
Phone (781) 331-5543
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 255 | MA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1396839130",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "166 LAKE SHORE DR",
"city": "WEYMOUTH",
"state": "MA",
"postal_code": "021891537",
"telephone_number": "781-331-5543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2100 DORCHESTER AVE",
"city": "DORCHESTER CENTER",
"state": "MA",
"postal_code": "021245615",
"telephone_number": "617-296-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITE",
"first_name": "MAUREEN",
"middle_name": "W",
"name_prefix": "Ms.",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "363AS0400X",
"taxonomy_group": "",
"desc": "Physician Assistant, Surgical",
"state": "MA",
"license": "255",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dorchester Center, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.