DR. PATRICIA JEAN OMALLEY (NPI# 1578544557) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578544557 |
| Entity Type | Individual |
| Full Name | DR. PATRICIA JEAN OMALLEY |
| Credential | MD |
| Practice Address |
55 Fruit St Ell 01 Pediaric Emergency Services Boston MA 02114-2696 |
| Mailing Address |
Po Box 9142 Mass General Physician Organization Charlestown MA 02129-9142 |
| Practice Telephone | 6177244110 |
| Practice Fax Number | 6177263231 |
| Mailing Telephone | 6177240287 |
| Mailing Fax Number | 6177262894 |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207PP0204X |
Emergency Medicine Specialization: Pediatric Emergency Medicine |
42857 | MA | Allopathic & Osteopathic Physicians |
| X | 208000000X | Pediatrics | 42857 | MA | Allopathic & Osteopathic Physicians |
| X | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
42857 | MA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MA | 0128082 | 05 | |
| MA | TUFTS HEALTH PLAN | 042857 | 01 |
| MA | BCBS MA | N01890 | 01 |
| Street Address |
55 FRUIT ST ELL 01 PEDIARIC EMERGENCY SERVICES |
| City | BOSTON |
| State | MA |
| Zip Code | 02114-2696 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568465888 | Michael A Nichols | Nurse Anesthetist, Certified Registered | 55 Fruit St, Boston, MA 02114-2696 | 2005-05-31 |
| 1740881374 | Katelyn Mary Bushey | Clinical Nurse Specialist | 55 Fruit St, Boston, MA 02114-2696 | 2020-11-02 |
| 1316546849 | Amy Lauren Greenblatt | Student in an Organized Health Care Education/Training Program | 55 Fruit St, Boston, MA 02114-2696 | 2020-10-26 |
| 1134728116 | Stephanie Qualls | Student in an Organized Health Care Education/Training Program | 55 Fruit St, Boston, MA 02114-2621 | 2020-10-21 |
| 1811596190 | Andrea S Hansen | Clinical Nurse Specialist | 55 Fruit St, Boston, MA 02114-2696 | 2020-10-19 |
| 1649879974 | Barbara Healy | Nurse Practitioner | 55 Fruit St, Boston, MA 02114-2696 | 2020-10-19 |
| 1770181117 | Molly Cristina Reynolds | Nurse Practitioner | 55 Fruit St, Boston, MA 02114-2621 | 2020-10-16 |
| 1245838325 | Katerina Eleni Kafkas | Nurse Practitioner | 55 Fruit St, Boston, MA 02114-2621 | 2020-10-12 |
| 1578179040 | Vivian Ellen Donahue | Registered Nurse | 55 Fruit St, Boston, MA 02114-2696 | 2020-09-21 |
| 1699380956 | Joanne Gover | Registered Nurse | 55 Fruit St, Boston, MA 02114-2621 | 2020-09-14 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588276281 | Guoliang Qiao | Student in an Organized Health Care Education/Training Program | Massachusetts General Hospital, 55 Fruit Street., Boston, MA 02114 | 2020-08-24 |
| 1881223741 | Alexander Wesley Zirulnik | Student in an Organized Health Care Education/Training Program | 55 Fruit St. Boston, Boston, MA 02114 | 2020-04-03 |
| 1376170548 | Mia Yu Bothwell | Student in an Organized Health Care Education/Training Program | Gray Bigelow 730, 55 Fruit Street, Boston, MA 02114 | 2020-03-26 |
| 1225661036 | David Dongkyung Kim | Student in an Organized Health Care Education/Training Program | 6 Whittier Place, Apartment 15b, Boston, MA 02114 | 2020-02-20 |
| 1124651658 | Madeleine Sertic | Student in an Organized Health Care Education/Training Program | Division of Abdominal Imaging, Department of Radiology, 55 Fruit Street, White 270, Boston, MA 02114 | 2020-02-12 |
| 1285274498 | Jiuk James Jung | Student in an Organized Health Care Education/Training Program | 15 Parkman Ave, Wang 4-460, Boston, MA 02114 | 2020-01-15 |
| 1831740448 | Jennifer Hughes | Physician Assistant | 55 Fruit Street, Founders 110, Boston, MA 02114 | 2019-09-25 |
| 1558827220 | Aluma Chovel Sella | Student in an Organized Health Care Education/Training Program | Massgeneral Hospital for Children Main Campus, 55 Fruit Street, Boston, MA 02114 | 2019-02-18 |
| 1083187140 | Henry Oliveras | Massage Therapist | 102 Charles Street, Boston, MA 02114 | 2019-01-10 |
| 1720550031 | Nicole M Price | Social Worker | 29 Staniford St, Boston, MA 02114 | 2018-12-27 |
| Find all providers in zip 02114 | ||||
| Taxonomy Code | 207PP0204X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| Specialization | Pediatric Emergency Medicine |
| Pediatric Emergency Medicine is a clinical subspecialty that focuses on the care of the acutely ill or injured child in the setting of an emergency department. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/ Board certification is provided by the American Board of Emergency Medicine. Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104065531 | Cyril Sahyoun | Emergency Medicine | 300 Longwood Ave, Boston, MA 02115-5724 | 2009-02-09 |
| 1275791931 | Raina Mitelia Paul | Emergency Medicine | 300 Longwood Ave, Department of Medicine-housestaff Lounge, Boston, MA 02115-5724 | 2008-05-29 |
| 1972572063 | Bruce W Weinstock | Emergency Medicine | 55 Fruit St, Boston, MA 02114-2621 | 2006-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912223470 | Anthony Brian Kitchen | Emergency Medicine | 759 Chestnut St, Springfield, MA 01199-1619 | 2010-04-08 |
| 1184861221 | Jennifer Jachowski | Emergency Medicine | 759 Chestnut St, Springfield, MA 01199-1619 | 2009-01-12 |
| 1093979403 | Jocelyn R Jensen | Emergency Medicine | 759 Chestnut St, Springfield, MA 01199-1619 | 2008-07-15 |
| 1407030331 | Elizabeth Ann Coray | Emergency Medicine | 57 Highland Ave, Salem, MA 01970 | 2007-12-27 |
| 1578619250 | Lindsey Christine Burghardt | Emergency Medicine | 340 Wood Rd, Suite 310, Braintree, MA 02184-2401 | 2007-01-26 |
| 1609884519 | Ian James Thornley | Emergency Medicine | 57 Highland Ave, North Shore Childrens Hospital Pediatric Emergency Room, Salem, MA 01970 | 2006-08-04 |
| 1083658686 | Paul Kotzampaltiris | Emergency Medicine | 115 Lincoln Street, Metrowest Medical Center, Framingham, MA 01702 | 2006-06-15 |
| 1639118722 | Joeli Hettler | Emergency Medicine | 759 Chestnut Street, Springfield, MA 01199-1619 | 2006-06-05 |
| 1700840162 | Jean Leigh Jackson | Emergency Medicine | 2014 Washington St, Newton, MA 02462 | 2006-04-13 |
| 1104887678 | Jill Zimmer Simon | Emergency Medicine | 2014 Washington St, Newton, MA 02462 | 2006-03-31 |
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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.