MEDICARE: DR. THOMAS R. MAYO M.D.

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	207LC0200X	Critical Care Medicine (Anesthesiology) Physician	259001	MA
2	207L00000X	Anesthesiology Physician	259001	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1386955144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS R. MAYO M.D.

Provider Business Mailing Address
First Line	:	55 WENDELL PARK
Second Line	:
City	:	MILTON
State	:	MA
Zip	:	02186-3117
Country	:	US
Telephone Number	:	617-304-9893
Fax Number	:

Provider Business Practice Location Address
First Line	:	199 REEDSDALE RD
Second Line	:
City	:	MILTON
State	:	MA
Zip	:	02186-3926
Country	:	US
Telephone Number	:	617-969-4600
Fax Number	:

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

Provider Enumeration Date	:	06/27/2010
Last Update Date	:	05/07/2026

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