Individual provider Active NPI

Ellen M McMahon, MD

  • Family Medicine Physician
  • Norway, ME
National Provider Identifier
1962468959
Registry record updated Sep 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD24876 Issued in ME
Practice address
8 Pikes HL
Norway, ME 04268-5340
Phone
(207) 744-6444
NPI assigned
Apr 26, 2006
Last updated
Sep 3, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 214075 MA
Geriatric Medicine (Family Medicine) Physician 207QG0300X 214075 MA
Family Medicine Physician 207Q00000X MD24876 ME Primary

Addresses

Primary practice location

8 Pikes HL
Norway, ME 04268-5340

Mailing address

8 Pikes HL
Norway, ME 04268-5340
Phone (207) 744-6444

Other identifiers 2

IdentifierTypeStateIssuer
2017918MedicaidMA
MD24876OtherMESTATE LICENSE

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
I20050811000288 MA Practitioner - Family PracticePractitioner - Plastic and Reconstructive SurgeryPractitioner - Geriatric Medicine 2668401472 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Geriatric MedicineAlso: Family Practice
Education
Warren Alpert Medical School of Brown University, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Martha's Vineyard Hospital IncGroup PAC ID 9931166113, shared by 5 NPIs, 150 clinicians

Practice addresses (Care Compare)

1 Hospital Rd
Oak Bluffs, MA 02557-1406
Phone 508693041079525

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
214075MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Martha's Vineyard Hospital, Inc. CurrentSince Aug 18, 2003 Accepting new patients
Martha's Vineyard Hospital, Inc. Family Medicine CurrentSince Aug 18, 2003 Accepting new patients
Martha's Vineyard Hospital Current Accepting new patients

Locations

1 Hospital Rd
Oak Bluffs, MA 02557
Phone (508) 684-4500

340 Main St
Ste 670
Worcester, MA 01608
Phone (508) 754-3560

Interoperability endpoints

  • Direct secure messaging: mcmahon.ellen.mvh@direct.partners.masshiway.net

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1146009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630627200000",
    "number": "1962468959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 PIKES HL",
            "city": "NORWAY",
            "state": "ME",
            "postal_code": "042685340",
            "telephone_number": "207-744-6444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 PIKES HL",
            "city": "NORWAY",
            "state": "ME",
            "postal_code": "042685340",
            "telephone_number": "207-744-6444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMAHON",
        "first_name": "ELLEN",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-26",
        "last_updated": "2021-09-03",
        "certification_date": "2021-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "214075",
            "primary": false
        },
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "MA",
            "license": "214075",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "MD24876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2017918",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MD24876",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norway, ME

Sources for this page

Verify at the official NPI Registry.