Individual provider Active NPI

Charlotte Alex Maguire, PMHNP-BC

  • Psychiatry Physician
  • Dedham, MA
National Provider Identifier
1861592313
Registry record updated Apr 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
261860 Issued in MA
Practice address
Dedham Consultation Center
339 Washington Street
Dedham, MA 02026
Phone
(781) 407-7770
Fax
(781) 326-7413
NPI assigned
Sep 25, 2006
Last updated
Apr 28, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN261860 MA
Psychiatry Physician 2084P0800X 261860 MA Primary

Addresses

Primary practice location

Dedham Consultation Center
339 Washington Street
Dedham, MA 02026

Mailing address

Dedham Consultation Center
339 Washington Street
Dedham, MA 02026
Phone (781) 407-7770

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180905002514 MA Practitioner - Nurse Practitioner 5496005860 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Dedham Consultation Center LLCGroup PAC ID 0749562106, 4 clinicians

Practice addresses (Care Compare)

339 Washington St
Suite 203
Dedham, MA 02026-1870
Phone (781) 407-7770

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN261860MAMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dedham Consultation Center LLC CurrentSince Apr 8, 2021 Accepting new patients

Locations

339 Washington St
Dedham, MA 02026
Phone (781) 329-1159

339 Washington St
Ste 203
Dedham, MA 02026
Phone (781) 326-0200

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682640000000",
    "number": "1861592313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEDHAM CONSULTATION CENTER",
            "address_2": "339 WASHINGTON STREET",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "02026",
            "telephone_number": "781-407-7770",
            "fax_number": "781-326-7413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "DEDHAM CONSULTATION CENTER",
            "address_2": "339 WASHINGTON STREET",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "02026",
            "telephone_number": "781-407-7770",
            "fax_number": "781-326-7413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGUIRE",
        "first_name": "CHARLOTTE",
        "middle_name": "ALEX",
        "credential": "PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-25",
        "last_updated": "2023-04-28",
        "certification_date": "2023-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN261860",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "261860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dedham, MA

Sources for this page

Verify at the official NPI Registry.