Active NPI
Mary Anne McKendall, MD
- Internal Medicine Physician
- Quincy, MA
National Provider Identifier
1679774988
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 49861
- 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, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 023987 | CT | MD | Internal Medicine Physician |
| MD027333E | PA | MD | Internal Medicine Physician |
| MD06152 | RI | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Healthworks, Inc | Internal Medicine | Past | Accepting new patients |
| Healthworks, Inc | Past | 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.
-
- Internal Medicine Physician
- Dedham, MA
- NPI 1447334560
-
- Ph.D. Medical Genetics
- Dedham, MA
- NPI 1619049657
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.