Active NPI
Matthew T McGonagle, MD
- Psychiatry Physician
- Boston, MA
National Provider Identifier
1598780231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 223459
- Practice address
- 750 Washington St
Dept of Psychiatry
Boston, MA 02111-1526 - Phone
- (617) 469-5385
- NPI assigned
- Jul 13, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 223459 | MA | Primary |
Addresses
Primary practice location
750 Washington St
Dept of Psychiatry
Boston, MA 02111-1526
Mailing address
186 Stratford St
#1
West Roxbury, MA 02132-2141
Phone (617) 469-5385
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20061108000356 | MA | Practitioner - Psychiatry | 5193722916 | Practice locations: Wellesley Hills, MA; Weston, MA |
Care Compare profile
Medicare Care Compare- Specialty
- Psychiatry
- Education
- Loyola University of Chicago, Stritch School of Medicine, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1 Hollis St
Suite 125
Wellesley, MA 02482-4631
Phone (781) 237-2030
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1598780231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "186 STRATFORD ST",
"address_2": "#1",
"city": "WEST ROXBURY",
"state": "MA",
"postal_code": "021322141",
"telephone_number": "617-469-5385",
"fax_number": "617-636-4852"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "750 WASHINGTON ST",
"address_2": "DEPT OF PSYCHIATRY",
"city": "BOSTON",
"state": "MA",
"postal_code": "021111526",
"telephone_number": "617-469-5385"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCGONAGLE",
"first_name": "MATTHEW",
"middle_name": "T",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "MA",
"license": "223459",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boston, 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.