MOUNT AUBURN HOSPITAL (NPI# 1255548251) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255548251 |
| Entity Type | Organization |
| Organization Name | MOUNT AUBURN HOSPITAL |
| Practice Address |
330 Mount Auburn St Cambridge MA 02138-5502 |
| Practice Telephone | 6174995700 |
| Practice Fax Number | 6174995422 |
| Mailing Telephone | 6174995700 |
| Mailing Fax Number | 6174995422 |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MS. JEANETTE CLOUGH (PRESIDENT AND CEO) |
| Authorized Official Telephone | 3174995700 |
| Authorized Official Credential | R.N. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| X | 2080N0001X |
Pediatrics Specialization: Neonatal-Perinatal Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | AETNA GROUP NUMBER | 2276276 | 01 |
| MA | 9760466 | 05 | |
| MA | TUFTS HEALTH PLAN | 722339 | 01 |
| MA | BLUE SHIELD OF MA | M16524 | 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 |
| 1649254491 | Mount Auburn Hospital | Psychiatric Unit | 330 Mount Auburn St, Cambridge, MA 02138-5502 | 2005-12-05 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | MOUNT AUBURN HOSPITAL | 330 Mt Auburn St, Cambridge, MA 02138-5502 |
| Massachusetts Corporations | MOUNT AUBURN HOSPITAL | 330 Mount Auburn St., Cambridge, MA 02138 |
| Massachusetts Corporations | MOUNT AUBURN HOSPITAL FOUNDATION, INC. | 330 Mt. Auburn St., Cambridge, MA 02138 |
| 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 |
| Find all providers in zip 02138 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255878922 | Jean C Kelley, Md | Pediatrics | 61 Fresh Pond Pkwy, Cambridge, MA 02138-3348 | 2017-01-19 |
| 1922493774 | Amy W Fan | Pediatrics | 575 Mount Auburn St Ste 202, Cambridge, MA 02138-4627 | 2015-03-30 |
| 1912343260 | Mary P Alexander | Pediatrics | 799 Concord Ave # 4, Cambridge, MA 02138-1048 | 2013-05-14 |
| 1053624452 | Gina Exantus-bernard | Pediatrics | 400 Byrn St Ste A, Cambridge, MD 21613 | 2010-07-14 |
| 1336260587 | Charles J Homer | Pediatrics | Nichq, 20 University Road, Cambridge, MA 02138 | 2007-04-03 |
| 1770609844 | Phyllis J Wagner | Pediatrics | 4 Crawford St, Cambridge, MA 02139-1624 | 2007-03-21 |
| 1083743967 | Brian L Hamilton | Pediatrics | Merimack Pharmaceuticals, 101 Binney Street, Cambridge, MA 02142 | 2007-03-05 |
| 1497881239 | Erin Margaret Mahony | Pediatrics | 799 Concord Avenue, Belmont Cambridge Health Care, Cambridge, MA 02138 | 2007-02-26 |
| 1073662037 | Julia Fowler Aquino | Pediatrics | 110 2nd St Ph 15, Cambridge, MA 02141-2147 | 2007-01-09 |
| 1629153119 | Edna J Dycoco | Pediatrics | 64979 Old Twenty On Road, Cambridge, OH 43725-9619 | 2006-10-25 |
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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.