Individual provider Active NPI

Amalie Thavikulwat Mays, MD

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1952792657
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
274715 Issued in MA
Practice address
330 Brookline Ave
Sherman 231
Boston, MA 02215
Phone
(617) 667-3552
Fax
(617) 667-3513
NPI assigned
Feb 17, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 125.071334 IL
Diagnostic Radiology Physician 2085R0202X 274715 MA Primary

Addresses

Primary practice location

330 Brookline Ave
Sherman 231
Boston, MA 02215

Mailing address

330 Brookline Ave
Sherman 231
Boston, MA 02215
Phone (617) 667-3552

Other practice location 1

240 E Huron St Ste 1-200
Chicago, IL 60611-2909
Phone (312) 503-7975

Other names 1

  • Dr. Amalie Catherine Thavikulwat Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125.071334ILMDInternal Medicine Physician
274715MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The General Hospital Corporation CurrentSince Jul 1, 2022 Accepting new patients
Harbor Medical Associates, Inc. Diagnostic Radiology CurrentSince Jul 1, 2022 Accepting new patients
Harbor Medical Associates, Inc. Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients
Massachusetts General Physicians Organization Inc Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients
Brigham & Womens Physicians Organization Inc Internal Medicine CurrentSince Jul 1, 2022 Accepting new patients

Locations

75 Francis St
Boston, MA 02115

55 Fruit St
Boston, MA 02114

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

541 Main St
Ste 201
South Weymouth, MA 02190
Phone (781) 335-4815

541 Main St
Ste 314
Weymouth, MA 02190
Phone (781) 952-1200

Organizations & group practices 5

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": "1424131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1952792657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "address_2": "SHERMAN 231",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02215",
            "telephone_number": "617-667-3552",
            "fax_number": "617-667-3513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 BROOKLINE AVE",
            "address_2": "SHERMAN 231",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02215",
            "telephone_number": "617-667-3552",
            "fax_number": "617-667-3513"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "240 E Huron St Ste 1-200",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112909",
            "country_code": "US",
            "telephone_number": "312-503-7975",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAYS",
        "first_name": "AMALIE",
        "middle_name": "THAVIKULWAT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-17",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "125.071334",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "274715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMALIE",
            "last_name": "THAVIKULWAT",
            "middle_name": "CATHERINE",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.