Individual provider Active NPI

Mary Anne McKendall, MD

  • Internal Medicine Physician
  • Quincy, MA
National Provider Identifier
1679774988
Registry record updated Jul 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
49861 Issued in MA
Practice address
One Enterprise Drive
Blue Cross Blue Shield of Massachusetts
Quincy, MA 02171
Phone
(617) 246-9922
NPI assigned
May 31, 2007
Last updated
Jul 5, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2010

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 49861 MA Primary
Internal Medicine Physician 207R00000X MD06152 RI
Internal Medicine Physician 207R00000X 023987 CT
Internal Medicine Physician 207R00000X MD027333E PA

Addresses

Primary practice location

One Enterprise Drive
Blue Cross Blue Shield of Massachusetts
Quincy, MA 02171

Mailing address

One Enterprise Drive
Blue Cross Blue Shield of Massachusetts
Quincy, MA 02171
Phone (617) 246-9922

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
023987CTMDInternal Medicine Physician
MD027333EPAMDInternal Medicine Physician
MD06152RIMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Healthworks, Inc Internal Medicine Past Accepting new patients
Healthworks, Inc PastSince Oct 1, 1990 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278288000000",
    "number": "1679774988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "ONE ENTERPRISE DRIVE",
            "address_2": "BLUE CROSS BLUE SHIELD OF MASSACHUSETTS",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "02171",
            "telephone_number": "617-246-9922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "ONE ENTERPRISE DRIVE",
            "address_2": "BLUE CROSS BLUE SHIELD OF MASSACHUSETTS",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "02171",
            "telephone_number": "617-246-9922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKENDALL",
        "first_name": "MARY ANNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-31",
        "last_updated": "2010-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "49861",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "RI",
            "license": "MD06152",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "023987",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "PA",
            "license": "MD027333E",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.