NPIMap

Organization Active NPI

Mount Auburn Hospital

  • Psychiatric Hospital Unit
  • Cambridge, MA
National Provider Identifier
1649254491
Registry record updated May 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric Hospital UnitTaxonomy code 273R00000X
License
2898 Issued in MA
Legal business name
MOUNT AUBURN HOSPITAL
Practice address
330 Mount Auburn St
Cambridge, MA 02138-5502
Phone
(617) 492-3500
Fax
(617) 499-5422
NPI assigned
Dec 5, 2005
Last updated
May 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2024

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

Authorized official

Name
Mr. Brian Smith
Title
Cfo
Phone
(405) 245-6238

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric Hospital Unit 273R00000X 2898 MA Primary

Addresses

Primary practice location

330 Mount Auburn St
Cambridge, MA 02138-5502

Mailing address

330 Mount Auburn St
Cambridge, MA 02138-5502
Phone (617) 492-3500

Other identifiers 9

IdentifierTypeStateIssuer
50-40078OtherMAUNITED HEALTHCARE
0007057OtherMANEIGHBORHOOD HEALTH PLAN
900749OtherMATUFTS ASSC HLTH PL-OUTPAT
900037OtherMATUFTS ASSC HLTH PL. INPAT
0012149OtherMAAETNA/US HEALTHCARE
996324OtherMANETWORK HEALTH PLAN
MOU2222000230OtherMABLUE X MASTER MEDICAL
1002150OtherMABEACON HEALTH-OUTPATIENT
245718OtherMAMAGELLAN/MA MERIT CLAIMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040329000378 MA Part B Supplier - Clinic/Group Practice 2668364183 Receives reassigned benefits from 43 practitioners
Practice locations: Cambridge, MA
O20210622000034 MA Part A Provider - Hospital 2668364183 Practice locations: Cambridge, MA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1649254491. Details of each certification follow.

Hospital certification: CCN 22S002

Legal name
MOUNT AUBURN HOSPITAL
Organization structure
CorporationNon-profit
Incorporated
Feb 23, 1871 in MA
Enrollment address
330 Mount Auburn St
Cambridge, MA 21385502
Hospital Psychiatric Unit
Hospital subgroups
Psychiatric unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory

Member organizations 3

Organizations listed as members of this organization in the National Provider Directory.

Locations

725 Concord Ave
Ste 5
Cambridge, MA 02138
Phone (617) 354-0546

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Susan Spurlock Individual Corporate DirectorMember/Board of Trustees Jan 1, 2019
John Macomber Individual Corporate DirectorChair/Board of Trustees Mar 1, 2019
Beth Israel Lahey Health, Inc. Organization, Boston, MA Created for acquisition, Corporation, Non-profit 5% Or Greater Direct Ownership Interest Mar 1, 2019 100%
Donna Smerlas Individual Corporate DirectorEx-Officio Oct 1, 2021
Mary Beams Individual Corporate DirectorVice Chair/Board of Trustees Oct 1, 2020
Edwin C Huang Individual Corporate OfficerPresident Feb 1, 2023
W-2 Managing EmployeePresident Feb 1, 2023
Michael J Shortsleeve Individual Corporate DirectorMember/Board of Trustees Jan 1, 2002
Christopher Shachoy Individual Corporate DirectorEx-Officio Jan 1, 2004
Brian Smith Individual Corporate OfficerCfo Mar 11, 2024
W-2 Managing Employee Mar 11, 2024
Daniel Calano Individual Corporate DirectorMember/Board of Trustees Apr 22, 2008

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Facilities with the same owner 18

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 18

Practitioners & affiliated clinicians

Practitioners 100

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 100

NPI Registry JSON

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

{
    "created_epoch": "1133740800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714867200000",
    "number": "1649254491",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 MOUNT AUBURN ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385502",
            "telephone_number": "617-492-3500",
            "fax_number": "617-499-5422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 MOUNT AUBURN ST",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385502",
            "telephone_number": "617-492-3500",
            "fax_number": "617-499-5422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNT AUBURN HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-05",
        "last_updated": "2024-05-05",
        "certification_date": "2024-05-05",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "405-245-6238",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "273R00000X",
            "taxonomy_group": "",
            "desc": "Psychiatric Unit",
            "state": "MA",
            "license": "2898",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "50-40078",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEIGHBORHOOD HEALTH PLAN",
            "identifier": "0007057",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS ASSC HLTH PL-OUTPAT",
            "identifier": "900749",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS ASSC HLTH PL. INPAT",
            "identifier": "900037",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA/US HEALTHCARE",
            "identifier": "0012149",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH PLAN",
            "identifier": "996324",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE X MASTER MEDICAL",
            "identifier": "MOU2222000230",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEACON HEALTH-OUTPATIENT",
            "identifier": "1002150",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN/MA MERIT CLAIMS",
            "identifier": "245718",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.