Individual provider Active NPI

Keryn Mahoney

  • Gerontology Nurse Practitioner
  • Weymouth, MA
National Provider Identifier
1982169017
Registry record updated May 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
RN254065 Issued in MA
Practice address
10 Patriot Pkwy Apt 313
Weymouth, MA 02190-0016
Phone
(617) 571-3296
NPI assigned
Feb 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical-Surgical Registered Nurse 163WM0705X RN254065 MA
Gerontology Nurse Practitioner 363LG0600X RN254065 MA Primary

Addresses

Primary practice location

10 Patriot Pkwy Apt 313
Weymouth, MA 02190-0016

Mailing address

10 Patriot Pkwy Apt 313
Weymouth, MA 02190-0016
Phone (617) 571-3296

Other practice location 1

541 Main St
South Weymouth, MA 02190-1868
Phone (781) 952-1280

Other practice location 2

56 New Driftway
Scituate, MA 02066-4533
Phone (781) 545-7243

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200615000545 MA Practitioner - Nurse Practitioner 7810319100 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Harbor Medical Associates IncGroup PAC ID 2466356209, 130 clinicians

Practice addresses (Care Compare)

2014 Washington St
Newton, MA 02462-1607
Phone (617) 243-6000

541 Main St
Suite 400
South Weymouth, MA 02190-1889
Phone (781) 952-1200

Hospital & facility affiliations

  • South Shore Visiting Nurse Association Home health agency, Rockland, MA, CCN 227082
  • Croi Health Home health agency, Norwell, MA, CCN 227241
  • South Shore Hospital Hospital, South Weymouth, MA, CCN 220100
  • Brigham and Women'S Hospital Hospital, Boston, MA, CCN 220110
  • Brigham and Women Faulkner Hospital Hospital, Jamaica Plain, MA, CCN 220119
  • Spaulding Rehabilitation Hospital Inpatient rehabilitation facility, Charlestown, MA, CCN 223034

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
RN254065MAMDMedical-Surgical Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Mass General Brigham Medical Group Suburban Massachusetts Inc CurrentSince Jan 1, 2026 Accepting new patients
Brigham and Women'S Hospital Current Accepting new patients
Harbor Medical Associates, Inc. CurrentSince Apr 28, 2020 Accepting new patients
Harbor Medical Associates, Inc. CurrentSince Apr 28, 2020 Accepting new patients

Locations

2014 Washington St
Newtonville, MA 02462
Phone (617) 243-6000

56 New Driftway
Scituate, MA 02066
Phone (781) 544-3434

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

541 Main St
Ste 400
Weymouth, MA 02190
Phone (781) 340-0100

541 Main St
Weymouth, MA 02190
Phone (781) 331-7866

Interoperability endpoints

  • Direct secure messaging: mahoney.keryn.bwh@direct.partners.masshiway.net

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 and National Provider Directory roles.

Hospital & facility affiliations 7

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": "1549152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590624000000",
    "number": "1982169017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 PATRIOT PKWY APT 313",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021900016",
            "telephone_number": "617-571-3296"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 PATRIOT PKWY APT 313",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021900016",
            "telephone_number": "617-571-3296"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "541 Main St",
            "address_purpose": "LOCATION",
            "city": "South Weymouth",
            "state": "MA",
            "postal_code": "021901868",
            "country_code": "US",
            "telephone_number": "781-952-1280",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "56 New Driftway",
            "address_purpose": "LOCATION",
            "city": "Scituate",
            "state": "MA",
            "postal_code": "020664533",
            "country_code": "US",
            "telephone_number": "781-545-7243",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MAHONEY",
        "first_name": "KERYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-03",
        "last_updated": "2020-05-28",
        "certification_date": "2020-05-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WM0705X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Medical-Surgical",
            "state": "MA",
            "license": "RN254065",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "MA",
            "license": "RN254065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Weymouth, MA

Sources for this page

Verify at the official NPI Registry.