Active NPI
Maisie Tam, MD
- Dermatology Physician
- Burlington, MA
National Provider Identifier
1841370517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- 41373
- Practice address
- 41 Mall Rd
Burlington, MA 01805-0001 - Phone
- (781) 744-8000
- Fax
- (781) 744-5687
- NPI assigned
- Oct 17, 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 |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 41373 | MA | Primary |
Addresses
Primary practice location
41 Mall Rd
Burlington, MA 01805-0001
Mailing address
41 Mall Rd
Burlington, MA 01805-0001
Phone (781) 744-8000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2072483 | Medicaid | MA |
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 |
|---|---|---|---|
| 41373 | MA | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1289865600000",
"number": "1841370517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41 MALL RD",
"city": "BURLINGTON",
"state": "MA",
"postal_code": "018050001",
"telephone_number": "781-744-8000",
"fax_number": "781-744-5687"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41 MALL RD",
"city": "BURLINGTON",
"state": "MA",
"postal_code": "018050001",
"telephone_number": "781-744-8000",
"fax_number": "781-744-5687"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAM",
"first_name": "MAISIE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-17",
"last_updated": "2010-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "MA",
"license": "41373",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2072483",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Burlington, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.