Individual provider Active NPI

Stephen P Maloney, MD

  • Vascular Surgery Physician
  • Brockton, MA
National Provider Identifier
1932369246
Registry record updated Sep 1, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
240061 Issued in MA
Practice address
110 Liberty St
Department of Surgery
Brockton, MA 02301-5521
Phone
(508) 894-0400
Fax
(508) 894-0757
NPI assigned
Jun 10, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery Physician 2086S0129X 240061 MA Primary
Surgery Physician 208600000X 240061 MA

Addresses

Primary practice location

110 Liberty St
Department of Surgery
Brockton, MA 02301-5521

Mailing address

110 Liberty Street
Department of Surgery
Brockton, MA 02301-5521
Phone (508) 894-0400

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
I20110907000767 MA Practitioner - Vascular Surgery 0840460564 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Vascular Surgery
Education
Boston University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Signature Healthcare Medical Group IncGroup PAC ID 7719876267, 250 clinicians

Practice addresses (Care Compare)

110 Liberty St
Brockton, MA 02301-5521
Phone (508) 894-0400

680 Centre St
Brockton, MA 02302-3308
Phone (508) 941-7000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.83 of 100Reported as group
Quality
70.13
Promoting interoperability
100
Improvement activities
40
Cost
75.97

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal14
Leg revascularization (restoring blood flow)1-10
Removal of tissue251

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
240061MAMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Healthcare Medical Group Inc Surgery CurrentSince Sep 1, 2011 Accepting new patients

Locations

110 Liberty St
Brockton, MA 02301

110 Liberty St
Ste 2C
Brockton, MA 02301

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

Interoperability endpoints

  • Direct secure messaging: stephen.maloney@direct.signature.masshiway.net

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1213056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314835200000",
    "number": "1932369246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 LIBERTY STREET",
            "address_2": "DEPARTMENT OF SURGERY",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015521",
            "telephone_number": "508-894-0400",
            "fax_number": "508-894-0757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LIBERTY ST",
            "address_2": "DEPARTMENT OF SURGERY",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015521",
            "telephone_number": "508-894-0400",
            "fax_number": "508-894-0757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALONEY",
        "first_name": "STEPHEN",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-10",
        "last_updated": "2011-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "MA",
            "license": "240061",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MA",
            "license": "240061",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.