Mary L Czymbor-Hepburn, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

79499 Issued in MA

Practice address

100 Scenic View Dr
Cumberland, RI 02864

Phone

(401) 770-9546

NPI assigned

Jul 28, 2006

Last updated

Jun 4, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 6

Addresses

Other identifiers 1

Other names 1

• Mary Lynn Czymbor Former name

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528070400000",
    "number": "1578577391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SCENIC VIEW DR",
            "city": "CUMBERLAND",
            "state": "RI",
            "postal_code": "028641783",
            "telephone_number": "401-770-9546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SCENIC VIEW DR",
            "city": "CUMBERLAND",
            "state": "RI",
            "postal_code": "02864",
            "telephone_number": "401-770-9546"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1153 Centre Street",
            "address_2": "Faulkner Hospital Ambulatory Clinic",
            "address_purpose": "LOCATION",
            "city": "Jamaica Plain",
            "state": "MA",
            "postal_code": "02130",
            "country_code": "US",
            "telephone_number": "617-983-7845",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CZYMBOR-HEPBURN",
        "first_name": "MARY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-28",
        "last_updated": "2018-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MI",
            "license": "4508778",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01079675B",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NJ",
            "license": "25MA10218100",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MD",
            "license": "D0085030",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "DC",
            "license": "MD045882",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "79499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3130916",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "CZYMBOR",
            "middle_name": "LYNN",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Tracey Marie D'Amico, OTR/L
• Courtney D'Angelo, LMHC

• Internal Medicine Physician in Cumberland, RI
• Providers in Cumberland, RI by specialty
• Internal Medicine Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.