1649254491 NPI number — MOUNT AUBURN HOSPITAL

Table of content: (NPI 1659471548)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649254491 NPI number — MOUNT AUBURN HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MOUNT AUBURN HOSPITAL
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1649254491
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/05/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
330 MOUNT AUBURN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CAMBRIDGE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02138-5502
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
617-492-3500
Provider Business Mailing Address Fax Number:
617-499-5422

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
330 MOUNT AUBURN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAMBRIDGE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02138-5502
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-492-3500
Provider Business Practice Location Address Fax Number:
617-499-5422
Provider Enumeration Date:
12/05/2005

Additional Information

Authorized Official

Authorized Official Last Name:
SMITH
Authorized Official First Name:
BRIAN
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
405-245-6238

Provider Taxonomy Codes

  • Taxonomy code: 273R00000X , with the licence number:  2898 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 50-40078 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 996324 . This is a "NETWORK HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0007057 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1002150 . This is a "BEACON HEALTH-OUTPATIENT" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0012149 . This is a "AETNA/US HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 245718 . This is a "MAGELLAN/MA MERIT CLAIMS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: MOU2222000230 . This is a "BLUE X MASTER MEDICAL" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 900037 . This is a "TUFTS ASSC HLTH PL. INPAT" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 900749 . This is a "TUFTS ASSC HLTH PL-OUTPAT" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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