Individual provider Active NPI

Bradley Allen Maron, M.D.

  • Cardiovascular Disease Physician
  • Boston, MA
National Provider Identifier
1962490417
Registry record updated Feb 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
226948 Issued in MA
Practice address
77 Avenue Louis Pasteur
Boston, MA 02115-5727
Phone
(617) 525-4803
NPI assigned
Oct 10, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2011

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 218965 MA
Cardiovascular Disease Physician 207RC0000X 226948 MA Primary

Addresses

Primary practice location

77 Avenue Louis Pasteur
Boston, MA 02115-5727

Mailing address

9 Borderland Rd
Sharon, MA 02067-3023
Phone (781) 784-4915

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20231201000525 MD Practitioner - Cardiovascular Disease (Cardiology) 6305941162 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

22 S Green St
Baltimore, MD 21201-1544
Phone (410) 328-8040

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
218965MAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University of Maryland Physicians P.a. Cardiovascular Disease CurrentSince Dec 1, 2023 Accepting new patients
University of Maryland Physicians P.a. CurrentSince Dec 1, 2023 Accepting new patients

Locations

22 S Greene St
Baltimore, MD 21201
Phone (410) 328-5793

419 W Redwood St
Baltimore, MD 21201
Phone (410) 328-5196

Interoperability endpoints

  • Direct secure messaging: bmaron1095401@direct.umm.edu

Organizations & group practices 2

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 1

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": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296864000000",
    "number": "1962490417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 BORDERLAND RD",
            "city": "SHARON",
            "state": "MA",
            "postal_code": "020673023",
            "telephone_number": "781-784-4915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 AVENUE LOUIS PASTEUR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155727",
            "telephone_number": "617-525-4803"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARON",
        "first_name": "BRADLEY",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-10",
        "last_updated": "2011-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "218965",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": "226948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.