DR. KATIE MAREE MOYNIHAN (NPI# 1699297374) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699297374 |
| Entity Type | Individual |
| Full Name | DR. KATIE MAREE MOYNIHAN |
| Credential | MD |
| Practice Address |
300 Longwood Ave Boston MA 02115-5724 |
| Mailing Address |
4 Hagar St Apt 2 Jamaica Plain MA 02130-4022 |
| Practice Telephone | 6177126121 |
| Mailing Telephone | 6177126121 |
| Enumeration Date | 2017-07-13 |
| Last Update Date | 2019-06-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2080P0202X |
Pediatrics Specialization: Pediatric Cardiology |
272208 | MA | Allopathic & Osteopathic Physicians |
| Y | 2080P0203X |
Pediatrics Specialization: Pediatric Critical Care Medicine |
276698 | MA | Allopathic & Osteopathic Physicians |
| Street Address |
300 LONGWOOD AVE |
| City | BOSTON |
| State | MA |
| Zip Code | 02115-5724 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588667539 | Barry Grant Zallen | Pediatrics | 300 Longwood Ave, Children's Hospital, Au 105, Boston, MA 02115-5724 | 2005-05-23 |
| 1730780669 | Hannah Fraser | Registered Nurse | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-11-06 |
| 1164023776 | Hannah Brewer | Social Worker | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-11-02 |
| 1104423680 | Justin Matthias Hintze | Otolaryngology | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-10-07 |
| 1295340388 | Kathryn Theresa Moffa | Psychologist | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-15 |
| 1144835224 | Abby Elizabeth Bandi | Social Worker | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-15 |
| 1558976845 | Hilary Segar Garber | Nurse Practitioner | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-13 |
| 1063026003 | Lauren M Dilullo | Psychologist | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-08 |
| 1013521004 | Carl Britto | Student in an Organized Health Care Education/Training Program | 300 Longwood Ave, Boston, MA 02115-5737 | 2020-09-07 |
| 1760096887 | Rebecca Marie Leslie | Nurse Practitioner | 300 Longwood Ave, Boston, MA 02115-5724 | 2020-09-04 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013524339 | Jacqueline Busa | Student in an Organized Health Care Education/Training Program | Northeastern University 336 Huntington Ave, Boston, MA 02115 | 2020-09-30 |
| 1417564279 | Katherine Rose Brainard | Student in an Organized Health Care Education/Training Program | 336 Huntington Avenue, Boston, MA 02115 | 2020-09-25 |
| 1679189112 | Tara Baxter | Orthopaedic Surgery | Boston Children's Hospital - Sports Medicine Division, 319 Longwood Avenue, Boston, MA 02115 | 2020-09-21 |
| 1053923110 | Wendy Tu | Student in an Organized Health Care Education/Training Program | 75 Francis Street Abdominal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115 | 2020-08-20 |
| 1477177335 | Nicolas Wyvekens | Student in an Organized Health Care Education/Training Program | 75 Francis Street Department of Pathology, Brigham And, Boston, MA 02115 | 2020-06-05 |
| 1669095923 | Erin Crocker | Student in an Organized Health Care Education/Training Program | Northeastern University Physician Assistant Program, 360 Huntington Avenue, Boston, MA 02115 | 2020-05-21 |
| 1033732417 | Tyler Francis Hayes | Student in an Organized Health Care Education/Training Program | Gordon Hall, Suite 213, 25 Shattuck Street, Boston, MA 02115 | 2020-05-20 |
| 1982225090 | Emily Blake | Student in an Organized Health Care Education/Training Program | 202 Robinson Hall, 360 Huntington Avenue, Boston, MA 02115 | 2020-04-29 |
| 1891315495 | Stephanie Schoch | Student in an Organized Health Care Education/Training Program | 360 Huntington Ave., 202 Robinson Hall, Boston, MA 02115 | 2020-04-23 |
| 1427678093 | Meghan Miles | Student in an Organized Health Care Education/Training Program | 360 Huntington Avenue 202 Robinson Hall, Boston, MA 02115 | 2020-04-23 |
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| Taxonomy Code | 2080P0203X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Critical Care Medicine |
| A pediatrician expert in advanced life support for children from the term or near-term neonate to the adolescent. This competence extends to the critical care management of life-threatening organ system failure from any cause in both medical and surgical patients and to the support of vital physiological functions. This specialist may have administrative responsibilities for intensive care units and also facilitates patient care among other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition changed, source added] Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. ACGME Accredited Residency Program Requirements: 2 years of training with 3 years Pediatrics plus 1 year Pediatric Critical Care for certification for a total of 6 years. ABMS Approved Subspecialty Certificate (Pediatrics) |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326699935 | Colin Meyer-macaulay | Pediatrics | 300 Longwood Ave, Boston, MA 02115-5724 | 2019-09-25 |
| 1902303480 | Haley Devries | Pediatrics | 300 Longwood Ave, Boston, MA 02115-5724 | 2018-04-10 |
| 1194272013 | Cheuk Chung Au | Pediatrics | 300 Longwood Ave, Bader 634, Boston, MA 02115-5724 | 2016-09-08 |
| 1215378435 | Peta-maree Ann Alexander | Pediatrics | Boston Children's Hospital, 300 Longwood Avenue, Cardiology Department, Boston, MA 02115 | 2013-07-16 |
| 1013352277 | Sarah Elyse Hendrickson | Pediatrics | 300 Longwood Ave, Boston, MA 02115-5724 | 2013-05-01 |
| 1841556305 | Jane Whitney | Pediatrics | 300 Longwood Ave, Boston, MA 02115-5724 | 2012-04-09 |
| 1891061768 | Jennifer Ann Blumenthal | Pediatrics | 300 Longwood Ave, Boston, MA 02115-5724 | 2012-03-26 |
| 1679848782 | Daniel Hames | Pediatrics | 300 Longwood Ave, Boston, MA 02115-5724 | 2012-03-22 |
| 1912297045 | Ben D Albert | Pediatrics | 300 Longwood Ave, Bader 634 - Critical Care Medicine, Boston, MA 02115-5724 | 2011-04-11 |
| 1033408513 | Mark David Dexter | Pediatrics | 800 Washington St, Boston, MA 02111-1552 | 2011-04-05 |
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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.