MEDICARE: JOHN J MAHONEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207LP2900X	Pain Medicine (Anesthesiology) Physician	25MB04990100	NJ
2	207LP2900X	Pain Medicine (Anesthesiology) Physician	OS005329L	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	P00117313	OTHER	PA	RAILROAD MEDICARE
12	P00125184	OTHER	PA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	22-1994560	OTHER	NJ	UNITED HEALTHCARE/OXFORD
2	23-2919275	OTHER	PA	PROCURA MANAGEMENT
4	22-1994560	OTHER	PA	HEALTH AMERICA/HEALTH ASSURANCE
5	23-2919275	OTHER	PA	GREAT WEST HEALTHCARE
6	0100369000	OTHER	PA	AMERIHEALTH
7	22-1994560	OTHER	PA	UNITED HEALTHCARE/OXFORD
8	23-2919275	OTHER	NJ	HORIZON BLUE CROSS BLUE SHIELD
9	30026840	OTHER	PA	KEYSTONE MERCY
10	435453	OTHER	PA	PA BLUE SHIELD
11	50088203	OTHER	PA	CAPITAL BLUE CROSS-CLINICAL PAIN MANAGMENT
13	1171572	OTHER	NJ	AETNA
14	22-1994560	OTHER	NJ	FIRST MCO
15	23-2919275	OTHER	PA	UNITED HEALTHCARE/OXFORD
16	23-2919275	OTHER	NJ	UNITED HEALTHCARE/OXFORD
17	1184660474	OTHER	PA	BRAVO
18	22-1994560	OTHER	PA	QUALCARE
19	22-1994560	OTHER	PA	FIRST MCO
20	22-1994560	OTHER	NJ	HORIZON BLUE CROSS BLUE SHIELD
21	23-2919275	OTHER	PA	FIRST MCO
22	30009932	OTHER	PA	HORIZON MERCY
23	1201983	OTHER	NJ	AETNA
24	23-2919275	OTHER	NJ	FIRST MCO
25	23-2919275	OTHER	PA	HEALTH AMERICA/HEALTH ASSURANCE
26	23-2919275	OTHER	PA	QUALCARE
27	23-2919275	OTHER	PA	DEVON
28	22-1994560	OTHER	PA	PROCURA MANAGEMENT
29	22-1994560	OTHER	PA	GREAT WEST HEALTHCARE
30	3107710	OTHER	PA	AETNA
31	3801579	OTHER	PA	AETNA
32	6039566	OTHER	PA	CIGNA
33	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
34	0100369000	OTHER	PA	KEYSTONE HEALTH PLAN EAST
35	22-1994560	OTHER	PA	DEVON
36	30026841	OTHER	PA	KEYSTONE MERCY
37	435453	OTHER	PA	PERSONAL CHOICE
38	50084647	OTHER	PA	CAPITAL BLUE CROSS
39	5614434	OTHER	PA	FIRST HEALTH NETWORK

General Provider Information

NPI Number	:	1184660474
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN J MAHONEY

Provider Business Mailing Address
First Line	:	PO BOX 33465
Second Line	:
City	:	BELFAST
State	:	ME
Zip	:	04915-0612
Country	:	US
Telephone Number	:	888-985-2727
Fax Number	:

Provider Business Practice Location Address
First Line	:	1400 ROUTE 70 E
Second Line	:
City	:	CHERRY HILL
State	:	NJ
Zip	:	08034-2240
Country	:	US
Telephone Number	:	888-985-2727
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2006
Last Update Date	:	04/18/2023

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