Individual provider Active NPI

Eduardo Antonio Maury, MD, PHD

  • Student in an Organized Health Care Education/Training Program
  • Boston, MA
National Provider Identifier
1871352310
Registry record updated May 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
60 Fenwood Rd
Boston, MA 02115-6128
Phone
(857) 201-4265
NPI assigned
Mar 18, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary

Addresses

Primary practice location

60 Fenwood Rd
Boston, MA 02115-6128

Mailing address

60 Fenwood Rd
Boston, MA 02115-6128
Phone (857) 201-4265

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
I20240715002632 MA Order and Referring Only - NeurosurgeryPractitioner - Neurosurgery 8527503549

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine, Doctor of Philosophy

NPI Registry JSON

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715212800000",
    "number": "1871352310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 FENWOOD RD",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156128",
            "telephone_number": "857-201-4265"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 FENWOOD RD",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156128",
            "telephone_number": "857-201-4265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAURY",
        "first_name": "EDUARDO",
        "middle_name": "ANTONIO",
        "name_prefix": "Dr.",
        "credential": "MD, PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-05-09",
        "certification_date": "2024-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.