Mauricio Masferrer, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

60217 Issued in GA

Practice address

300 East Hospital Road, 13 Floor. Obhs
Dwight D Eisenhower Army Medical Center
Fort Gordon, GA 30905-5650

Phone

(706) 787-2039

Fax

(706) 787-5625

NPI assigned

Aug 19, 2005

Last updated

Dec 10, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TX, GA2 enrollments

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 2

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Department of Behavioral Health and Developmental Disabilities

  dba Central State Hospital

  • Psychiatric Hospital
  • Milledgeville, GA
  • NPI 1902030307
  Medicare reassignment NPD
• SGMP Southland LLC

  • Psychiatry Physician
  • Valdosta, GA
  • NPI 1447695085
  Medicare reassignment NPD
• DHHS,PHS,Naihs, Gallup Indian Medical Center

  • General Acute Care Hospital
  • Gallup, NM
  • NPI 1225002322

  TX

  Medicare reassignment NPD
• Choice Family Medicine, PC

  • Primary Care Clinic/Center
  • Valdosta, GA
  • NPI 1609087469
  NPD
• Department of Behavioral Health & Developmental Disabilities

  dba Georgial Regional Hospital at Savannah

  • Psychiatric Hospital
  • Savannah, GA
  • NPI 1942432737
  NPD
• Department of Behavioral Health & Developmental Disabilities, Ga

  dba Southwest Community Clinic

  • Neurology Physician
  • Thomasville, GA
  • NPI 1174942684
  NPD

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

{
    "created_epoch": "1124409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386633600000",
    "number": "1972595429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 EAST HOSPITAL ROAD, BUILDING 300, 13 FLOOR. OBHS",
            "address_2": "DWIGHT D EISENHOWER ARMY MEDICAL CENTER",
            "city": "FORT GORDON",
            "state": "GA",
            "postal_code": "309055650",
            "telephone_number": "706-787-2039",
            "fax_number": "706-787-5625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 EAST HOSPITAL ROAD, 13 FLOOR. OBHS",
            "address_2": "DWIGHT D EISENHOWER ARMY MEDICAL CENTER",
            "city": "FORT GORDON",
            "state": "GA",
            "postal_code": "309055650",
            "telephone_number": "706-787-2039",
            "fax_number": "706-787-5625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASFERRER",
        "first_name": "MAURICIO",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-08-19",
        "last_updated": "2013-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "KS",
            "license": "0418009",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "GA",
            "license": "60217",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "987753",
            "state": "AZ"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "86935828",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jennifer E. Markyna, LCSW
• Gordon Andrew Marshall, PHYSICIAN ASSISTANT
• Eric David Martin, D.O.
• Brendan Martino, DO
• Clarice Dewitt Marty, LPTA
• Robert Mathis, MSW
• Anne-Marie May, BSN
• John William McCann, DDS
• Cedric F McCord, MD
• Anthony McCormick, PH.D.

• Psychiatry Physician in Fort Gordon, GA
• Providers in Fort Gordon, GA by specialty
• Psychiatry Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.