MOUNT AUBURN HOSPITAL (NPI# 1649254491) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649254491 |
| Entity Type | Organization |
| Organization Name | MOUNT AUBURN HOSPITAL |
| Practice Address |
330 Mount Auburn St Cambridge MA 02138-5502 |
| Practice Telephone | 6174923500 |
| Practice Fax Number | 6174995422 |
| Mailing Telephone | 6174923500 |
| Mailing Fax Number | 6174995422 |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. JEANETTE CLOUGH (PRESIDENT/CEO) |
| Authorized Official Telephone | 6174995700 |
| Authorized Official Credential | R.N. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 273R00000X | Psychiatric Unit | 2898 | MA | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | NETWORK HEALTH PLAN | 996324 | 01 |
| MA | BLUE X MASTER MEDICAL | MOU2222000230 | 01 |
| MA | MAGELLAN/MA MERIT CLAIMS | 245718 | 01 |
| MA | NEIGHBORHOOD HEALTH PLAN | 0007057 | 01 |
| MA | AETNA/US HEALTHCARE | 0012149 | 01 |
| MA | BEACON HEALTH-OUTPATIENT | 1002150 | 01 |
| MA | UNITED HEALTHCARE | 50-40078 | 01 |
| MA | TUFTS ASSC HLTH PL-OUTPAT | 900749 | 01 |
| MA | TUFTS ASSC HLTH PL. INPAT | 900037 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902880016 | Mount Auburn Hospital | Home Health | 1 Arsenal Market Pl, Watertown, MA 02472-5018 | 2005-12-01 |
| 1811540727 | Mount Auburn Hospital | Internal Medicine | 330 Mount Auburn St, Cambridge, MA 02138-5502 | 2019-07-19 |
| 1538542006 | Mount Auburn Hospital | General Acute Care Hospital | 330 Mount Auburn St, Cambridge, MA 02138-5502 | 2015-07-02 |
| 1710360292 | Mount Auburn Hospital | General Acute Care Hospital | 330 Mount Auburn St, Cambridge, MA 02138-5502 | 2015-07-02 |
| 1124374707 | Mount Auburn Hospital | Internal Medicine | 330 Mount Auburn St, Cambridge, MA 02138-5502 | 2012-08-01 |
| 1518212554 | Mount Auburn Hospital | General Acute Care Hospital | 330 Mount Auburn St, Cambridge, MA 02138-5502 | 2012-07-16 |
| 1902168339 | Mount Auburn Hospital | General Acute Care Hospital | 330 Mount Auburn Street, Cambridge, MA 02138-5502 | 2012-06-12 |
| 1326352576 | Mount Auburn Hospital | General Acute Care Hospital | 330 Mount Auburn St, Cambridge, MA 02138-5502 | 2010-07-29 |
| 1588863179 | Mount Auburn Hospital | Clinic/Center | 725 Concord Ave, Occupational Health 5th Floor, Cambridge, MA 02138-1040 | 2007-07-13 |
| 1255548251 | Mount Auburn Hospital | Pediatrics | 330 Mount Auburn St, Cambridge, MA 02138-5502 | 2007-05-17 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MOUNT AUBURN HOSPITAL | 330 Mt Auburn St, Cambridge, MA 02138-5502 |
| Street Address |
330 MOUNT AUBURN ST |
| City | CAMBRIDGE |
| State | MA |
| Zip Code | 02138-5502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407859762 | Susan A Abookire | Internal Medicine | 330 Mount Auburn St, Cambridge, MA 02138-5502 | 2005-05-31 |
| 1013515279 | Alaaeldin Ahmed | Student in an Organized Health Care Education/Training Program | 330 Mount Auburn St, Cambridge, MA 02138-5597 | 2020-10-10 |
| 1447863618 | Omar Hamzeh Al Omari | Internal Medicine | 330 Mount Auburn St, Cambridge, MA 02138-5502 | 2020-08-27 |
| 1043833221 | Nicholas D Gottshall | Physician Assistant | 330 Mount Auburn St, Cambridge, MA 02138-5502 | 2020-05-22 |
| 1881217263 | Claire C Alexanian | Student in an Organized Health Care Education/Training Program | 330 Mount Auburn St, Cambridge, MA 02138-5597 | 2020-05-20 |
| 1689297087 | Arun Cumpelik | Student in an Organized Health Care Education/Training Program | 330 Mount Auburn St, Cambridge, MA 02138-5502 | 2020-05-20 |
| 1104448125 | Alireza Ghajar | Student in an Organized Health Care Education/Training Program | 330 Mount Auburn St, Cambridge, MA 02138-5502 | 2020-05-13 |
| 1902427768 | Alexis Sholtis | Social Worker | 330 Mount Auburn St, Cambridge, MA 02138-5502 | 2020-05-04 |
| 1043839814 | Max Joseph Wallack | Student in an Organized Health Care Education/Training Program | 330 Mount Auburn St, Cambridge, MA 02138-5502 | 2020-04-13 |
| 1821617010 | Hezha Seradji Aghdam | Student in an Organized Health Care Education/Training Program | 330 Mount Auburn St, Cambridge, MA 02138-5502 | 2020-04-09 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922618610 | Khushboo Vijay Bhatia | Student in an Organized Health Care Education/Training Program | Internal Medicine Residency Program, Mount Auburn Hospi, 330 Mt. Auburn Street, Cambridge, MA 02138 | 2020-08-06 |
| 1780204156 | Ashna Grover | Student in an Organized Health Care Education/Training Program | 330 Mt Auburn Street Mount Auburn Hospital, Internal Medicine Residency Program, Cambridge, MA 02138 | 2020-04-25 |
| 1790330298 | Cambridge Periodontics LLC | Dentist | 1692 Massachusetts Ave Ste 3, Cambridge, MA 02138 | 2019-08-02 |
| 1295389765 | Yulia Levit | Technician/Technologist | 1208 Massachussets Av, Cambridge, MA 02138 | 2019-08-01 |
| 1720645393 | Chinmay Tusharkumar Jani | Student in an Organized Health Care Education/Training Program | Mount Auburn Hospital, 330 Mt Auburn Street, Cambridge, MA 02138 | 2019-05-20 |
| 1386209831 | Alexander Ryan Walker | Internal Medicine | 300 Mount Auburn Street Mount Auburn Hospital, Dept. of Medicine, Cambridge, MA 02138 | 2019-05-09 |
| 1659844868 | Aimee Hsieh | Social Worker | 525 Mount Auburn Street, Cambridge, MA 02138 | 2019-01-10 |
| 1043733389 | Armida Fruzzetti | Psychologist | 900 Concord Avenue, Cambridge, MA 02138 | 2017-07-19 |
| 1174984827 | Jenna Mezin Schmid | Psychologist | 75 Mt Auburn St 4 East, Harvard University Health Services, Cambridge, MA 02138 | 2016-03-09 |
| 1316313208 | Kelly Abbott | Optometrist | 12 Eliot St., Cambridge, MA 02138 | 2015-08-14 |
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| Taxonomy Code | 273R00000X |
| Grouping | Hospital Units |
| Classification | Psychiatric Unit |
| In general, a distinct unit of a hospital that provides acute or long-term care to emotionally disturbed patients, including patients admitted for diagnosis and those admitted for treatment of psychiatric problems on the basis of physicians' orders and approved nursing care plans. Long-term care may include intensive supervision to the chronically mentally ill, mentally disordered or other mentally incompetent persons; (2) For Medicare, a distinct part of a general acute care hospital admitting only patients whose admission to the unit is required for active treatment, whose treatment is of an intensity that can be provided only in an inpatient hospital setting, and whose condition is described by a psychiatric principal diagnosis contained in the Third Edition of the American Psychiatric Association Diagnostic and Statistical Manual or in Chapter 5 (Mental Disorders) of the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). The unit must furnish, through the use of qualified personnel, psychological services, social work services, psychiatric nursing, occupational therapy, and recreational therapy. The unit must maintain medical records that permit determination of the degree and intensity of treatment provided to individuals who are furnished services in the unit; the unit must meet special staff requirements in that the unit must have adequate numbers of qualified professional and supportive staff to evaluate inpatients, formulate written, individualized, comprehensive treatment plans, provide active treatment measures and engage in discharge planning. |
| Notes: Source: (1) AHA Annual Survey p. A10 1996 AHA Guide; (2) Code of Federal Regulations #42, Section 412.27. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215184486 | Corey Todd Levy | Psychiatric Unit | 1493 Cambridge Street, Cambridge, MA 02139 | 2008-08-19 |
| 1285803213 | Mt Auburn Hospital Dept of Psychiatry | Psychiatric Unit | 330 Mount Auburn St, Clark 1, Cambridge, MA 02138-5502 | 2008-02-25 |
| 1770789216 | Cambridge Health Alliance | Psychiatric Unit | 1493 Cambridge St, Cambridge, MA 02139-1047 | 2007-06-22 |
| 1447348313 | Cambridge Public Health Commission | Psychiatric Unit | 1493 Cambridge St, Cambridge, MA 02139-1047 | 2006-10-10 |
| 1285694091 | Shore Health System, Inc | Psychiatric Unit | 300 Byrn St, Cambridge, MD 21613-1908 | 2006-03-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225261589 | Cambridge Health Alliance | Psychiatric Unit | 153 Leyden St Apt 2, East Boston, MA 02128-2617 | 2009-09-02 |
| 1467641126 | Boston Healthcare Va | Psychiatric Unit | 204 Bellingham Ave, Revere, MA 02151-4106 | 2007-10-18 |
| 1528261690 | Northshore Medical Center | Psychiatric Unit | 172 Lafayette St., Salem, MA 01970 | 2007-06-07 |
| 1629062906 | The Mercy Hospital Inc | Psychiatric Unit | 1233 Main St, Holyoke, MA 01040 | 2005-09-01 |
| 1194250290 | Mclean Hospital | Psychiatric Unit | 30 Warren St, Brighton, MA 02135-3602 | 2017-04-26 |
| 1285171934 | Umass Memorial Healthalliance Clinton Hospital Inc | Psychiatric Unit | 201 Highland St, Clinton, MA 01510-1037 | 2017-01-19 |
| 1700216850 | Nashoba Valley Medical Center, A Steward Family Hospital, Inc. | Psychiatric Unit | 200 Groton Rd, Ayer, MA 01432-1168 | 2013-11-26 |
| 1225399785 | Brockton Multi Services | Psychiatric Unit | 165 Quincy St, Brockton, MA 02302-2988 | 2012-05-31 |
| 1720369036 | Quincy Medical Center, A Steward Family Hospital, Inc. | Psychiatric Unit | 114 Whitwell St, Quincy, MA 02169-1870 | 2011-08-31 |
| 1376822676 | Morton Hospital, A Steward Family Hospital, Inc. | Psychiatric Unit | 88 Washington St, Taunton, MA 02780-2465 | 2011-08-04 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.