Marie C McCormick, MD, DSC

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

58490 Issued in MA

Practice address

677 Huntington Ave
Boston, MA 02115-6028

Phone

(617) 432-3759

Fax

(617) 432-3755

NPI assigned

Aug 5, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831108109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "478 QUINOBEQUIN RD",
            "city": "WABAN",
            "state": "MA",
            "postal_code": "024682127",
            "telephone_number": "617-965-8279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "677 HUNTINGTON AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156028",
            "telephone_number": "617-432-3759",
            "fax_number": "617-432-3755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORMICK",
        "first_name": "MARIE",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD, DSC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "58490",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3193140",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Charles E. McCorkle, LICSW
• Genevieve McCormack
• Luke McCormack, MD
• Catherine McCormick, CCC-SLP
• Janelle Rose McCormick, MS, RDN, LDN
• Matthew James McCormick, M.D.
• Michelle McCormick
• Pamela McCormick, NP
• Robert McCormick, MD
• Shelley Rose McCormick

• Pediatrics Physician in Boston, MA
• Providers in Boston, MA by specialty
• Pediatrics Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.

Verify at the official NPI Registry.