Mara Nussbaum

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

76865 Issued in MA

Practice address

74 Bridge St
Newton, MA 02458

Phone

(617) 969-4410

NPI assigned

Aug 2, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Creative Connections Pediatrics LLC

  • Speech-Language Pathologist
  • Cambridge, MA
  • NPI 1114663762
  NPD Authorized official
• Occupational Therapy Associates - Watertown, Inc.

  • Clinic/Center
  • Newton, MA
  • NPI 1750429072
  NPD (past)
• Ota the Koomar Center, LLC

  • Pediatric Occupational Therapist
  • Newton, MA
  • NPI 1679167720
  NPD (past)

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

{
    "created_epoch": "1501632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531180800000",
    "number": "1497279210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 BRIDGE ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "024581147",
            "telephone_number": "617-969-4410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 BRIDGE ST",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "02458",
            "telephone_number": "617-969-4410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUSSBAUM",
        "first_name": "MARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-02",
        "last_updated": "2018-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "76865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda D Norton, MSN, ANP-BC, GNP-BC
• Sheila Frances Norton, CNM, ANP-BC
• Nourished With Rachael LLC
• Kiahtay Nuahn
• Ana Nunez Aleman
• Nwas
• Meaghan O Carroll
• Joseph E O'Brien, D.M.D.
• Erin O'Connell, PA-C
• Erin Marie O'Connor

• Speech-Language Pathologist in Newton, MA
• Providers in Newton, MA by specialty
• Speech-Language Pathologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2018; 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.