Individual provider Active NPI

Miles Gregory Cunningham, M.D.

  • Psychiatry Physician
  • Belmont, MA
National Provider Identifier
1922014331
Registry record updated Sep 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
208781 Issued in MA
Practice address
115 Mill St
Belmont, MA 02478-1041
Phone
(617) 855-2051
Fax
(617) 855-3199
NPI assigned
Jul 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 208781 MA Primary

Addresses

Primary practice location

115 Mill St
Belmont, MA 02478-1041

Mailing address

115 Mill St
Belmont, MA 02478-1041
Phone (617) 855-2051

Other identifiers 1

IdentifierTypeStateIssuer
J24111OtherMABCBS

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
I20040907000185 MA Practitioner - Psychiatry 2062488612 Reassigns benefits to 2 organizations
Practice locations: Belmont, MA

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Harvard Medical School, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

68 Leonard St
Suite 3
Belmont, MA 02478-2522
Phone (617) 855-2051

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
208781MAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The McLean Hospital Corporation Psychiatry CurrentSince May 23, 2009 Accepting new patients
Square Medical Group LLC CurrentSince Feb 1, 2013 Accepting new patients
The McLean Hospital Corporation Past Accepting new patients

Locations

115 Mill St
Belmont, MA 02478
Phone (617) 855-2000

884 Washington St
Fl 1
Weymouth, MA 02189
Phone (781) 812-1643

884 Washington St
Fl 2
Weymouth, MA 02189
Phone (617) 447-2146

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221177600000",
    "number": "1922014331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 MILL ST",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024781041",
            "telephone_number": "617-855-2051",
            "fax_number": "617-855-3199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MILL ST",
            "city": "BELMONT",
            "state": "MA",
            "postal_code": "024781041",
            "telephone_number": "617-855-2051",
            "fax_number": "617-855-3199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "MILES",
        "middle_name": "GREGORY",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2008-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "MA",
            "license": "208781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "J24111",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Belmont, MA

Sources for this page

Verify at the official NPI Registry.