Individual provider Active NPI

Diana Shea Mahoney, FNP-BC

  • Family Nurse Practitioner
  • Lawrence, MA
National Provider Identifier
1528400975
Registry record updated Feb 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN2269660 Issued in MA
Practice address
73D Winthrop Ave
Lawrence, MA 01843-3716
Phone
(978) 686-3017
Fax
(978) 685-4280
NPI assigned
Jul 26, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN2269660 MA Primary

Addresses

Primary practice location

73D Winthrop Ave
Lawrence, MA 01843-3716

Mailing address

73D Winthrop Ave
Lawrence, MA 01843-3716
Phone (978) 686-3017

Other names 1

  • Diana Shea Barry Former name

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
I20141224000330 MA Practitioner - Nurse Practitioner 5395068399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
LGH Medical Group, Inc.Group PAC ID 3173626751, 165 clinicians

Practice addresses (Care Compare)

1574 Main St
Suite 200
Tewksbury, MA 01876-2067
Phone (978) 323-2819

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
RN2269660MAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
LGH Medical Group, Inc. CurrentSince Jun 5, 2023 Accepting new patients
LGH Professional Services LLC Past Accepting new patients

Locations

295 Varnum Ave
Lowell, MA 01854
Phone (978) 788-7344

1574 Main St
Ste 200
Tewksbury, MA 01876
Phone (978) 323-2819

Interoperability endpoints

  • Direct secure messaging: dmahoney31639@tuftsmedicine.direct-ci.com

Organizations & group practices 2

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 2

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": "1374796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423526400000",
    "number": "1528400975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73D WINTHROP AVE",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018433716",
            "telephone_number": "978-686-3017",
            "fax_number": "978-685-4280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "73D WINTHROP AVE",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018433716",
            "telephone_number": "978-686-3017",
            "fax_number": "978-685-4280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "DIANA",
        "middle_name": "SHEA",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-26",
        "last_updated": "2015-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MA",
            "license": "RN2269660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DIANA",
            "last_name": "BARRY",
            "middle_name": "SHEA",
            "credential": "FNP-BC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lawrence, MA

Sources for this page

Verify at the official NPI Registry.