Active NPI
William J. Mullally, MD
- Neurology Physician
- Braintree, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 46261
- Practice address
- 111 Grossman Dr
Neurology
Braintree, MA 02184-4997 - Phone
- (781) 849-2265
- Fax
- (781) 849-2274
- NPI assigned
- Sep 29, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 46261 | MA | |
| Neurology Physician | 2084N0400X | 46261 | MA | Primary |
Addresses
Primary practice location
111 Grossman Dr
Neurology
Braintree, MA 02184-4997
Mailing address
147 Milk St
Provider Enrollment 9TH Floor
Boston, MA 02109-4806
Phone (617) 421-6540
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 111404 | Other | MA | HARVARD PILGRIM |
| 0014880 | Other | MA | NEIGHBORHOOD HEALTH PLAN |
| 3179591 | Medicaid | MA | |
| 046261 | Other | MA | TUFTS HEALTH PLAN |
| P00086706 | Other | MA | MEDICARE RAILROAD |
| J12153 | Other | MA | BLUE CROSS |
| 7011385-002 | Other | MA | CIGNA |
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
Care Compare profile
Medicare Care Compare- Specialty
- Neurology
- Education
- Rutgers R W Johnson Medical School (Cam/New Bruns/Pisc), 1976
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brigham and Women's Faulkner Hospital, Inc | Current | Accepting new patients | |
| Brigham and Womens Physicians Organization Inc | Past | Accepting new patients | |
| Atrius Health, Inc. | Internal Medicine | Past | Accepting new patients |
Locations
75 Francis St
Boston, MA 02115
1153 Centre St
Jamaica Plain, MA 02130
Phone (617) 983-7000
1153 Centre St
#L1
Jamaica Plain, MA 02130
Interoperability endpoints
- wmullally188678@direct.ochin.org
- mullally.william.bwh@direct.partners.masshiway.net
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Internal Medicine Physician
- Boston, MA
- NPI 1033535497
-
- General Acute Care Hospital
- Boston, MA
- NPI 1578677811
-
dba Harvard Vanguard Medical Associates
- Internal Medicine Physician
- Boston, MA
- NPI 1740238526
-
- Diagnostic Radiology Physician
- Boston, MA
- NPI 1265464598
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Boston, MA
- NPI 1790717650
-
- General Acute Care Hospital
- Boston, MA
- NPI 1578677811
-
- Psychiatric Hospital Unit
- Boston, MA
- NPI 1033121025
-
dba Spaulding Rehabilitation Hospital - Cape Cod
- Rehabilitation Hospital
- E Sandwich, MA
- NPI 1265489736
Inpatient rehabilitation facility
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1307404800000",
"number": "1659463339",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "147 MILK ST",
"address_2": "PROVIDER ENROLLMENT 9TH FLOOR",
"city": "BOSTON",
"state": "MA",
"postal_code": "021094806",
"telephone_number": "617-421-6540"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 GROSSMAN DR",
"address_2": "NEUROLOGY",
"city": "BRAINTREE",
"state": "MA",
"postal_code": "021844997",
"telephone_number": "781-849-2265",
"fax_number": "781-849-2274"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MULLALLY",
"first_name": "WILLIAM",
"middle_name": "J.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-29",
"last_updated": "2011-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MA",
"license": "46261",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "MA",
"license": "46261",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HARVARD PILGRIM",
"identifier": "111404",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NEIGHBORHOOD HEALTH PLAN",
"identifier": "0014880",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3179591",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TUFTS HEALTH PLAN",
"identifier": "046261",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE RAILROAD",
"identifier": "P00086706",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "J12153",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "7011385-002",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Braintree, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2011; 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.