Mystic Valley Urological Associates Inc.

Primary specialty

Urology PhysicianTaxonomy code 208800000X

Legal business name

MYSTIC VALLEY UROLOGICAL ASSOCIATES INC.

Practice address

3 Woodland Rd
Suite 216
Stoneham, MA 02180-1702

Phone

(781) 979-0661

Fax

(781) 979-0372

NPI assigned

Jul 30, 2006

Organization subpart

No

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

Authorized official

Name

Marjie C Haluska

Title

Director of Business Operations

Phone

(781) 979-0661

Specialties & licenses 1

Addresses

Other identifiers 6

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paul F Kelly, M.D.

  • Urology Physician
  • Stoneham, MA
  • NPI 1437184454
  NPD

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478476800000",
    "number": "1740295575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 WOODLAND RD",
            "address_2": "SUITE 216",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021801702",
            "telephone_number": "781-979-0661",
            "fax_number": "781-979-0372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 WOODLAND RD",
            "address_2": "SUITE 216",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021801702",
            "telephone_number": "781-979-0661",
            "fax_number": "781-979-0372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MYSTIC VALLEY UROLOGICAL ASSOCIATES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2016-11-07",
        "status": "A",
        "authorized_official_last_name": "HALUSKA",
        "authorized_official_first_name": "MARJIE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS OPERATIONS",
        "authorized_official_telephone_number": "781-979-0661"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Urology",
            "state": "MA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RRMED",
            "identifier": "CL0638",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "28749",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "600296",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHP",
            "identifier": "0009638",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9723757",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSMA",
            "identifier": "M13568",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erin P Murphy, N.P.
• Nicholas Musto
• Mystic Valley Dermatology Associates, P.C.
• Mystic Valley Mass, PC
• Mystic Valley Urological Assoc Inc
• Mystic Valley Urological Associates, Inc
• XI NA, M.D., PH.D.
• Kanta Nagpaul, M.D.
• Jane Namatovu
• Olivia Namubiru, LPN

• Urology Physician in Stoneham, MA
• Providers in Stoneham, MA by specialty
• Urology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2016; 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.