DR. RANDOLPH DAVID MALONEY (NPI# 1518977271) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518977271 |
| Entity Type | Individual |
| Full Name | DR. RANDOLPH DAVID MALONEY |
| Credential | M.D. |
| Practice Address |
75 Herrick St Ste 110 Beverly MA 01915-5900 |
| Practice Telephone | 9789225535 |
| Practice Fax Number | 9789225667 |
| Mailing Telephone | 9789225535 |
| Mailing Fax Number | 9789225667 |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2083P0011X |
Preventive Medicine Specialization: Undersea and Hyperbaric Medicine |
35297 | MA | Allopathic & Osteopathic Physicians |
| N | 208600000X | Surgery | 35297 | MA | Allopathic & Osteopathic Physicians |
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
35297 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | PHCS | 113976 | 01 |
| MA | 2017415 | 05 | |
| MA | BLUECROSS/BLUESHIELD | 70010000B46035 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 500 Cummings Ctr Ste 1800, Beverly, MA 019156141 | 9789211210 | 9789211534 |
| Street Address |
75 HERRICK ST STE 110 |
| City | BEVERLY |
| State | MA |
| Zip Code | 01915-5900 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497377253 | Janice E. Schwartz | Psychologist | 100 Cummings Center, 232 C, Beverly, MA 01915 | 2020-05-14 |
| 1720625452 | Campos Dental Care PC | Dentist | 127 Dodge Street, Beverly, MA 01915 | 2019-12-02 |
| 1144781477 | Nutrimedy | Dietitian, Registered | 6 Oceanside Drive, Beverly, MA 01915 | 2019-03-28 |
| 1376001073 | Benjamin David Stebbings | Counselor | 199 Rosewood Dr. Suite 250, Beverly, MA 01915 | 2019-03-12 |
| 1376000455 | Patrick Matthew Noble | Occupational Therapist | Peer Projects - Therapy From The Heart, 100 Cummings Center Suite 350g, Beverly, MA 01915 | 2019-02-26 |
| 1174007900 | Nicole Morreo | Psychologist | 480 Rantoul St., 208, Beverly, MA 01915 | 2018-09-18 |
| 1891282299 | Jeanne Tomich | Psychologist | 110 Hart St., Beverly, MA 01915 | 2018-04-20 |
| 1518469089 | Kathleen L Golemon | Specialist | 100 Cummings Center Suite 158-d, Beverly, MA 01915 | 2018-03-01 |
| 1629582556 | Sarah Elizabeth Tsouvalas | Nurse Practitioner | 900 Cummings Center, Suite 111w, Lahey Health Primary Care, Beverly, Beverly, MA 01915 | 2017-11-30 |
| 1235657339 | Kathleen Ann Downey | Registered Nurse | Element Care, 166d Cummings Center, Beverly, MA 01915 | 2017-09-08 |
| Find all providers in zip 01915 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| 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 Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548462096 | North Shore Vascular, P.C. | Surgery | 900 Cummings Ctr, Suite 118t, Beverly, MA 01915-6198 | 2007-06-05 |
| 1689767758 | Beverly Surgical Associates Inc | Surgery | 75 Herrick St, Suite 201, Beverly, MA 01915 | 2006-10-02 |
| 1386625895 | John Thomas Dooley | Surgery | 500 Cummings Ctr, Suite 1650, Beverly, MA 01915-6142 | 2005-11-10 |
| 1639150733 | Henry A Frissora | Surgery | 83 Herrick St, Suite 3001, Beverly, MA 01915-2757 | 2005-11-07 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942815022 | Stephen J. Hoenig, Md, PC | Surgery | 114 Merriam Ave Ste 101, Leominster, MA 01453-3175 | 2020-09-15 |
| 1578084588 | Stephen J. Hoenig, Md, PC | Surgery | 50 Memorial Dr Ste 112, Leominster, MA 01453-2238 | 2017-06-29 |
| 1760776124 | Brad Sherman Oriel | Surgery | 955 Main St Ste G2a, Winchester, MA 01890-1992 | 2011-06-02 |
| 1750697157 | Dorothy Virginia Freeman | Surgery | 21 Washburn Ave, Wellesley, MA 02481-5263 | 2010-08-23 |
| 1245551696 | Khaled A. Yehia Md | Surgery | 178 Savin St Ste 500, Malden, MA 02148-2329 | 2010-06-21 |
| 1932332707 | Usa Vein Clinics of Boston LLC | Surgery | 1208b Vfw Pkwy Ste 300, West Roxbury, MA 02132-4350 | 2009-08-27 |
| 1255563334 | Samuel Schwartz | Surgery | 15 Parkman St # 440, Boston, MA 02114-3117 | 2009-08-21 |
| 1053551838 | Jonathan Paull Gertler | Surgery | 15 Westcliff Rd, Weston, MA 02493-1409 | 2009-03-06 |
| 1093952939 | Sarah Carlson | Surgery | 1400 Vfw Pkwy # 1c-105, West Roxbury, MA 02132-4927 | 2009-01-14 |
| 1437314325 | Sandip T Maru | Surgery | 2 Hospital Dr Ste 2013, Holyoke, MA 01040 | 2008-07-21 |
| Find all providers with the same taxonomy | ||||
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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.