Nicole L Mahoney, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

43010083001 Issued in MI

Practice address

43097 Woodward Ave
Ste 201
Bloomfield Hills, MI 48302-5041

Phone

(248) 454-9000

Fax

(248) 454-9100

NPI assigned

Jan 15, 2007

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Pediatric Specialists of Bloomfield Hills,P.C

  • Pediatrics Physician
  • Bloomfield Hills, MI
  • NPI 1023197357
  NPD (past)
• Endeavor Health Medical Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD (past)
• Endeavor Health Medical Group

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217376000000",
    "number": "1881745271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "43097 WOODWARD AVE",
            "address_2": "STE 201",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483025041",
            "telephone_number": "248-454-9000",
            "fax_number": "248-454-9100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43097 WOODWARD AVE",
            "address_2": "STE 201",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483025041",
            "telephone_number": "248-454-9000",
            "fax_number": "248-454-9100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "NICOLE",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-15",
        "last_updated": "2008-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "43010083001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "350F361320",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4592222",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Erwin Isaac Madorsky, DR OF DENTAL SURGERY
• Mark David Madorsky, DR OF DENTAL SURGERY
• Rula Mahayni, MD
• Zaid Ali Mahdi, M.D.
• Saima Mahi, LLBSW
• Donna Major
• Sarah Makadsi, MD
• Erik Joseph Makie, PSY.D.
• Making It Matter Counseling, PLLC
• Sandra Lynn Makram, D.D.S.

• Pediatrics Physician in Bloomfield Hills, MI
• Providers in Bloomfield Hills, MI by specialty
• Pediatrics Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; 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.