Basic Information
| Provider Information | |||||||||
| NPI: | 1528049772 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MOSTONE | ||||||||
| FirstName: | REGINA | ||||||||
| MiddleName: | M | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DPM | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 HOSPITAL RD | ||||||||
| Address2: | |||||||||
| City: | OAK BLUFFS | ||||||||
| State: | MA | ||||||||
| PostalCode: | 025571406 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5086844500 | ||||||||
| FaxNumber: | 5086844502 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 HOSPITAL RD | ||||||||
| Address2: | |||||||||
| City: | OAK BLUFFS | ||||||||
| State: | MA | ||||||||
| PostalCode: | 025571406 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5086844500 | ||||||||
| FaxNumber: | 5086844502 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/07/2005 | ||||||||
| LastUpdateDate: | 07/26/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 07/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 213ES0131X | 1903 | MA | Y | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot Surgery |
ID Information
| ID | Type | State | Issuer | Description | 001903 | 01 | MA | TUFTS HEALTH PLAN | OTHER | 22730 | 01 | MA | FALLON HEALTH PLAN | OTHER | 27-00020 | 01 | MA | UNITED HEALTHCARE | OTHER | B20354101 | 01 | MA | CIGNA | OTHER | Y70898 | 01 | MA | BLUE SHIELD OF MA | OTHER | S002873 | 01 | MA | CHAMPUS/TRICARE | OTHER |