Active NPI
Mary-Ellin Moore, FNP
- Family Nurse Practitioner
- Newton, MA
National Provider Identifier
1689618720
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 160595
- Practice address
- 83 Littlefield Rd
Newton, MA 02459-3010 - Phone
- (617) 928-1530
- Fax
- (617) 928-1531
- NPI assigned
- Jun 16, 2006
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 160595 | MA | Primary |
Addresses
Primary practice location
83 Littlefield Rd
Newton, MA 02459-3010
Mailing address
48 Maverick St
Dedham, MA 02026-2436
Phone (781) 326-8193
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NP4210 | Other | MA | BC/BS PROVIDER NUMBER |
| 0327484 | Medicaid | MA | |
| P00043183 | Other | MA | RR-FEDERAL BLUE CROSS |
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
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Senior Healthcare Associates Inc | Family | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Geriatric Medicine (Internal Medicine) Physician
- Newton, MA
- NPI 1730126871
Family
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150416000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1689618720",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "48 MAVERICK ST",
"city": "DEDHAM",
"state": "MA",
"postal_code": "020262436",
"telephone_number": "781-326-8193",
"fax_number": "781-326-8193"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "83 LITTLEFIELD RD",
"city": "NEWTON",
"state": "MA",
"postal_code": "024593010",
"telephone_number": "617-928-1530",
"fax_number": "617-928-1531"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MOORE",
"first_name": "MARY-ELLIN",
"name_prefix": "Ms.",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-06-16",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MA",
"license": "160595",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS PROVIDER NUMBER",
"identifier": "NP4210",
"state": "MA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0327484",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RR-FEDERAL BLUE CROSS",
"identifier": "P00043183",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.