MICHAEL MOONEY (NPI# 1790124691) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790124691 |
| Entity Type | Individual |
| Full Name | MICHAEL MOONEY |
| Credential | MD |
| Practice Address |
60 Fenwood Rd Boston MA 02115-6128 |
| Practice Telephone | 2489330570 |
| Practice Fax Number | 6022948286 |
| Mailing Telephone | 2489330570 |
| Mailing Fax Number | 6022948286 |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2020-09-21 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207T00000X | Neurological Surgery | 284117 | MA | Allopathic & Osteopathic Physicians |
| N | 207T00000X | Neurological Surgery | 281414 | MA | Allopathic & Osteopathic Physicians |
| N | 207T00000X | Neurological Surgery | MCS004591A | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | AZ TRAINING PERMIT | R74142 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376913822 | Michael J. Mooney | Nurse Practitioner | 3901 Beaubien, 3rd Floor Carl's Bldg,, #3g32, Children's Hospital of Mi, Detroit, MI 48201-2153 | 2015-09-28 |
| 1679912406 | Michael J. Mooney | Family Medicine | 965 Emerson Pkwy Ste J, Greenwood, IN 46143 | 2013-06-14 |
| 1841314952 | Michael Patrick Mooney | Optometrist | 4815 W Braker Ln Ste 560, Austin, TX 78759-5661 | 2007-03-16 |
| 1952734626 | Michael Alexander Mooney | Dentist | Usa Meddac Bavaria, Unit 28038, Apo, AA 09112 | 2013-08-16 |
| 1124396361 | Michael H Mooney | Registered Nurse | 4500 W Midway Rd, Fort Pierce, FL 34981-4823 | 2011-12-02 |
| 1598919995 | Michael Joseph Mooney | Psychologist | 27730 Gratiot Ave, Roseville, MI 48066-4885 | 2008-11-11 |
| 1609985647 | Michael Joseph Mooney | Surgery | 2211 E Mill Plain Blvd, Vancouver, WA 98661-4329 | 2006-08-30 |
| 1982657748 | Michael Joseph Mooney | Social Worker | 800 Poly Pl, Brooklyn, NY 11209-7104 | 2006-05-19 |
| 1619931847 | Michael R Mooney | Internal Medicine | 800 E 28th St, Suite H2100, Minneapolis, MN 55407-3723 | 2006-04-14 |
| 1578543229 | Michael Todd Mooney | Dentist | 250 Makalapa Dr, Compacflt Health Services (n01hd) Attn: Professional A, Pearl Harbor, HI 96860-3131 | 2006-01-19 |
| Street Address |
60 FENWOOD RD |
| City | BOSTON |
| State | MA |
| Zip Code | 02115-6128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881619088 | Laura Morrissey | Social Worker | 60 Fenwood Rd, Boston, MA 02115-6128 | 2006-07-12 |
| 1689204356 | John Michael Sullivan | Physician Assistant | 60 Fenwood Rd, Boston, MA 02115-6128 | 2020-01-22 |
| 1841856044 | Alexandra Leaverton | Physician Assistant | 60 Fenwood Rd, Boston, MA 02115-6128 | 2019-05-13 |
| 1053872895 | Emma Eleanor Taylor Pennock | Physician Assistant | 60 Fenwood Rd, Boston, MA 02115 | 2019-03-26 |
| 1538624135 | Nathaniel Bernardo | Physician Assistant | 60 Fenwood Rd, Boston, MA 02115-6128 | 2019-02-07 |
| 1205307600 | Margaret E Naclerio | Physician Assistant | 60 Fenwood Rd, Boston, MA 02115-6128 | 2018-12-10 |
| 1144700535 | Nadim Jiwa | Psychiatry & Neurology | 60 Fenwood Rd, Boston, MA 02115-6128 | 2018-08-15 |
| 1972009033 | Sanjali Kumar | Student in an Organized Health Care Education/Training Program | 60 Fenwood Rd, Boston, MA 02115-6128 | 2018-04-05 |
| 1699270710 | Nishant Kumar Gupta | Student in an Organized Health Care Education/Training Program | 60 Fenwood Rd, Boston, MA 02115-6128 | 2018-03-29 |
| 1992200125 | Natalie Feldman | Student in an Organized Health Care Education/Training Program | 60 Fenwood Rd, Boston, MA 02115-6128 | 2018-03-28 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524339 | Jacqueline Busa | Student in an Organized Health Care Education/Training Program | Northeastern University 336 Huntington Ave, Boston, MA 02115 | 2020-09-30 |
| 1417564279 | Katherine Rose Brainard | Student in an Organized Health Care Education/Training Program | 336 Huntington Avenue, Boston, MA 02115 | 2020-09-25 |
| 1679189112 | Tara Baxter | Orthopaedic Surgery | Boston Children's Hospital - Sports Medicine Division, 319 Longwood Avenue, Boston, MA 02115 | 2020-09-21 |
| 1053923110 | Wendy Tu | Student in an Organized Health Care Education/Training Program | 75 Francis Street Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115 | 2020-08-20 |
| 1477177335 | Nicolas Wyvekens | Student in an Organized Health Care Education/Training Program | 75 Francis Street Department of Pathology, Brigham And, Boston, MA 02115 | 2020-06-05 |
| 1669095923 | Erin Crocker | Student in an Organized Health Care Education/Training Program | Northeastern University Physician Assistant Program, 360 Huntington Avenue, Boston, MA 02115 | 2020-05-21 |
| 1033732417 | Tyler Francis Hayes | Student in an Organized Health Care Education/Training Program | Gordon Hall, Suite 213, 25 Shattuck Street, Boston, MA 02115 | 2020-05-20 |
| 1982225090 | Emily Blake | Student in an Organized Health Care Education/Training Program | 202 Robinson Hall, 360 Huntington Avenue, Boston, MA 02115 | 2020-04-29 |
| 1891315495 | Stephanie Schoch | Student in an Organized Health Care Education/Training Program | 360 Huntington Ave., 202 Robinson Hall, Boston, MA 02115 | 2020-04-23 |
| 1427678093 | Meghan Miles | Student in an Organized Health Care Education/Training Program | 360 Huntington Avenue 202 Robinson Hall, Boston, MA 02115 | 2020-04-23 |
| Find all providers in zip 02115 | ||||
| Taxonomy Code | 207T00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Neurological Surgery |
| A neurological surgeon provides the operative and non-operative management (i.e., prevention, diagnosis, evaluation, treatment, critical care, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify function or activity of the nervous system; and the operative and non-operative management of pain. A neurological surgeon treats patients with disorders of the nervous system; disorders of the brain, meninges, skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland; disorders of the spinal cord, meninges, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added] Additional Resources: American Board of Neurological Surgery, 2007. http://www.abns.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Neurological Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932729597 | Jacob Joseph Kosarchuk | Neurological Surgery | 800 Washington Street, Proger 7, Boston, MA 02111 | 2020-04-23 |
| 1376021279 | Felix Nwajei | Neurological Surgery | 725 Albany St # 7c, Boston, MA 02118-2526 | 2018-08-02 |
| 1740627579 | Christian Strong | Neurological Surgery | 75 Francis St # Ab-136, Boston, MA 02115-6110 | 2013-06-03 |
| 1518251834 | Zachary Luke Tataryn | Neurological Surgery | 197 Beacon St, Apartment 3r, Boston, MA 02116-1461 | 2011-06-03 |
| 1598932154 | Yi Lu | Neurological Surgery | 75 Francis St, Ca455, Department of Neurosurgery, Brigham & Women's Hospital, Boston, MA 02115-6110 | 2008-05-13 |
| 1770775256 | Ron I Riesenburger | Neurological Surgery | 800 Washington Street Box 178, Tufts Medical Center, Boston, MA 02111 | 2007-08-17 |
| 1033234562 | Justin M Brown | Neurological Surgery | 55 Fruit St # 745, Boston, MA 02114-2621 | 2007-03-21 |
| 1154498152 | Raymond Kevin Ryan | Neurological Surgery | 1 Adirondack Pl, Boston, MA 02124-5603 | 2006-11-29 |
| 1083626907 | Ann-christine Duhaime | Neurological Surgery | 55 Fruit St # 331, Boston, MA 02114-2621 | 2006-08-12 |
| 1972525541 | Ajith J Thomas | Neurological Surgery | 110 Francis Street, Suite 3b, Boston, MA 02215 | 2006-07-24 |
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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.