MT AUBURN PROFESSIONAL SERVICES (NPI# 1992750996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1992750996 |
| Entity Type | Organization |
| Organization Name | MT AUBURN PROFESSIONAL SERVICES |
| Practice Address |
One Arsenal Marketplace Watertown MA 02472-2861 |
| Practice Telephone | 6176731851 |
| Practice Fax Number | 6174995579 |
| Mailing Telephone | 6174995644 |
| Mailing Fax Number | 6174995620 |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2019-09-09 |
| Authorized Official Name | AGNES M NUNZIATO (CREDENTIALING ADMINISTRATOR) |
| Authorized Official Telephone | 6176731851 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians | ||
| N | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians | ||
| N | 207RI0200X |
Internal Medicine Specialization: Infectious Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
Allopathic & Osteopathic Physicians | ||
| N | 2084N0400X |
Psychiatry & Neurology Specialization: Neurology |
Allopathic & Osteopathic Physicians | ||
| N | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians | ||
| N | 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) | Allopathic & Osteopathic Physicians | ||
| N | 208M00000X | Hospitalist | Allopathic & Osteopathic Physicians | ||
| N | 225100000X | Physical Therapist | 5121 | MA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | BLUE SHIELD | M14923 | 01 |
| MA | TUFTS | 603255 | 01 |
| MA | 110078204C | 05 | |
| MA | TUFTS | 604027 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013375203 | Mt Auburn Professional Services | Anesthesiology | 725 Concord Ave, Suite 4100, Cambridge, MA 02138-1040 | 2016-02-03 |
| 1184907859 | Mt Auburn Professional Services | Podiatrist | 725 Concord Ave, Suite 3600, Cambridge, MA 02138-1040 | 2011-09-20 |
| 1164640306 | Mt Auburn Professional Services | Emergency Medicine | One Arsenal Marketplace, Watertown, MA 02472 | 2007-04-23 |
| 1407865439 | Mt Auburn Professional Services | Obstetrics & Gynecology | One Arsenal Marketplace, Watertown, MA 02472 | 2006-08-07 |
| 1013921790 | Mt Auburn Professional Services | Internal Medicine | 20 Holland St, Suite 407, Somerville, MA 02144-2700 | 2006-07-28 |
| Street Address |
ONE ARSENAL MARKETPLACE |
| City | WATERTOWN |
| State | MA |
| Zip Code | 02472-2861 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609291376 | Mt Auburn Professional Obgyn | Obstetrics & Gynecology | One Arsenal Marketplace, Watertown, MA 02472-2861 | 2014-03-04 |
| 1255674636 | Mt Auburn Prof Services | Internal Medicine | One Arsenal Marketplace, Watertown, MA 02472-2861 | 2013-04-03 |
| 1164640306 | Mt Auburn Professional Services | Emergency Medicine | One Arsenal Marketplace, Watertown, MA 02472 | 2007-04-23 |
| 1407865439 | Mt Auburn Professional Services | Obstetrics & Gynecology | One Arsenal Marketplace, Watertown, MA 02472 | 2006-08-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548735327 | Gladys Nakungu Kasansula | Counselor | Square Medical Group, 124 Watertown Street, Suite 2d, Watertown, MA 02472 | 2018-10-09 |
| 1447741962 | Hannah Edward | Optometrist | 550 Arsenal Street, Watertown, MA 02472 | 2018-05-21 |
| 1982193504 | Ruth Audrey Silverstein | Social Worker | Perkins School for The Blind, 175 North Beacon Street, Watertown, MA 02472 | 2018-05-09 |
| 1376067355 | Mostafa Medhati | Acupuncturist | 265 Lexington St., Watertown, MA 02472 | 2017-08-01 |
| 1003346313 | Eric Trant | Specialist/Technologist | 50 Columbia Street, Watertown, MA 02472 | 2017-06-19 |
| 1477007730 | Neangkanika Chea | Nurse Practitioner | 2 Repton Place, Apt 2204, Watertown, MA 02472 | 2016-08-04 |
| 1396128120 | Michelle Soares Darocha | Dentist | 18 Hovey Street, Watertown, MA 02472 | 2015-06-29 |
| 1760875496 | Ece Evin Yildirim | Acupuncturist | 557 Mt. Auburn St, Watertown, MA 02472 | 2015-03-05 |
| 1396140927 | Fabrizia Torazzi | Behavioral Analyst | 51 Water Street, Suite 200, Watertown, MA 02472 | 2014-10-24 |
| 1265774392 | Emilia Ann Fulop | Social Worker | 127 North Beacon Street, Watertown, MA 02472 | 2013-03-27 |
| Find all providers in zip 02472 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376839563 | Terrell Yancy Johnson | Internal Medicine | 590 Main St Unit 205, Watertown, MA 02472-2117 | 2011-06-26 |
| 1235363490 | Ingrid Margot Hall | Internal Medicine | 629 Washington St Ste 2, Watertown, NY 13601-4083 | 2009-05-03 |
| 1467613356 | Maximilian Gomez-trochez | Internal Medicine | 51 Depot St Ste 202, Watertown, CT 06795-2667 | 2008-06-23 |
| 1700046083 | John P. Moschello, Md, PC | Internal Medicine | 594 Mount Fair Dr, Watertown, CT 06795-1661 | 2008-06-11 |
| 1265639116 | Steven Edward Shamosh | Internal Medicine | 169 Bishop St, Watertown, NY 13601-4603 | 2007-07-02 |
| 1831238625 | Wayne S Wild | Internal Medicine | 705 Mount Auburn Street, Tufts Health Plan, Watertown, MA 02472-1508 | 2007-02-06 |
| 1891843645 | Victor Peter Wasilauskas | Internal Medicine | 10 Brookview Cir, Watertown, CT 06795-1231 | 2007-01-08 |
| 1700964848 | Martha N Martents | Internal Medicine | 48 Summer Street, Suite 1, Watertown, MA 02472-3815 | 2006-11-02 |
| 1043396112 | Gerald George Fette | Internal Medicine | 246 Winding Brook Farm Road, Watertown, CT 06795-0144 | 2006-10-31 |
| 1225146848 | Ronald Joseph Dandrea | Internal Medicine | 51 Depot Street, Watertown, CT 06795 | 2006-08-25 |
| Find all providers in WATERTOWN | ||||
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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.