Individual provider Active NPI

Maryanne C Bombaugh, M.D.

  • Obstetrics & Gynecology Physician
  • Plymouth, MA
National Provider Identifier
1962477224
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
75493 Issued in MA
Practice address
118 Long Pond Rd
Plymouth, MA 02360-2662
Phone
(508) 830-3190
Fax
(781) 340-3782
NPI assigned
Feb 21, 2006
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 75493 MA Primary

Addresses

Primary practice location

118 Long Pond Rd
Plymouth, MA 02360-2662

Mailing address

107 Commercial St
Mashpee, MA 02649-6507
Phone (508) 539-6000

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
I20050516000043 MA Practitioner - Obstetrics/Gynecology 9335180827 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Texas Medical School at San Antonio, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

107 Commercial St
Mashpee, MA 02649-6507
Phone (508) 477-7090

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center of Cape Cod Inc CurrentSince May 27, 2022 Accepting new patients
Community Health Center of Cape Cod, Inc. CurrentSince May 27, 2022 Accepting new patients
Jordan Physician Associates, Inc. Past Accepting new patients
Jordan Physician Associates, Inc. Obstetrics & Gynecology Past Accepting new patients

Locations

107 Commercial St
Mashpee, MA 02649
Phone (508) 539-6000

Organizations & group practices 4

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": "1140480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1962477224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 COMMERCIAL ST",
            "city": "MASHPEE",
            "state": "MA",
            "postal_code": "026496507",
            "telephone_number": "508-539-6000",
            "fax_number": "508-477-7028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 LONG POND RD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602662",
            "telephone_number": "508-830-3190",
            "fax_number": "781-340-3782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOMBAUGH",
        "first_name": "MARYANNE",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-21",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MA",
            "license": "75493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.