Individual provider Active NPI

Julie Anne Moran, D.O.

  • Geriatric Medicine (Internal Medicine) Physician
  • Tewksbury, MA
National Provider Identifier
1841231925
Registry record updated Jan 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
2211140 Issued in MA
Practice address
365 East Street
Tewksbury Hospital
Tewksbury, MA 01876-1998
Phone
(978) 851-7321
Fax
(978) 851-3640
NPI assigned
Jun 9, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 2211140 MA Primary

Addresses

Primary practice location

365 East Street
Tewksbury Hospital
Tewksbury, MA 01876-1998

Mailing address

300 N Main St
Andover, MA 01810-3003
Phone (978) 851-7321

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060816000415 MA Practitioner - Geriatric MedicinePractitioner - Internal Medicine 4183627953 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Internal Medicine
Education
Rowan University School of Osteopathic Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Commonwealth of MassachusettsGroup PAC ID 8820906860, 141 clinicians

Practice addresses (Care Compare)

365 E St
Tewksbury Hospital
Tewksbury, MA 01876-1998
Phone (978) 851-7321

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2211140MAMDGeriatric Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Commonwealth of Massachusetts CurrentSince Jun 3, 2013 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince May 13, 2010 Accepting new patients
Beth Israel Deaconess Medical Center, Inc. CurrentSince May 13, 2010 Accepting new patients
The Commonwealth of Massachusetts CurrentSince Jun 3, 2013 Accepting new patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc Past Accepting new patients

Locations

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

365 East St
Tewksbury, MA 01876
Phone (617) 536-2186

Organizations & group practices 5

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422489600000",
    "number": "1841231925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N MAIN ST",
            "city": "ANDOVER",
            "state": "MA",
            "postal_code": "018103003",
            "telephone_number": "978-851-7321",
            "fax_number": "978-851-3640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 EAST STREET",
            "address_2": "TEWKSBURY HOSPITAL",
            "city": "TEWKSBURY",
            "state": "MA",
            "postal_code": "018761998",
            "telephone_number": "978-851-7321",
            "fax_number": "978-851-3640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORAN",
        "first_name": "JULIE",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2015-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "MA",
            "license": "2211140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tewksbury, MA

Sources for this page

Verify at the official NPI Registry.