Organization Active NPI

Seacoast Medical Associates, PC

  • Internal Medicine Physician
  • Newburyport, MA
National Provider Identifier
1003039926
Registry record updated Dec 31, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
153766 Issued in MA
Legal business name
SEACOAST MEDICAL ASSOCIATES, PC
Practice address
21 Highland Ave
Suite 24
Newburyport, MA 01950-3872
Phone
(978) 462-1555
Fax
(978) 462-1560
NPI assigned
Apr 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Robin Macdonald
Title
Office Manager
Phone
(978) 462-1555

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207R00000X 153766 MA Primary

Addresses

Primary practice location

21 Highland Ave
Suite 24
Newburyport, MA 01950-3872

Mailing address

21 Highland Ave
Suite 24
Newburyport, MA 01950-3872
Phone (978) 462-1555

Other identifiers 3

IdentifierTypeStateIssuer
M15982OtherPTAN
A30492OtherIND MEDICARE PROVIDER NUM
9773649MedicaidMA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
22D2317892Revere Medical Seacoast Associates21 Highland Avenue Suite 24, Newburyport, MA 01950Certificate of waiverFeb 2, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419984000000",
    "number": "1003039926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 HIGHLAND AVE",
            "address_2": "SUITE 24",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "019503872",
            "telephone_number": "978-462-1555",
            "fax_number": "978-462-1560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 HIGHLAND AVE",
            "address_2": "SUITE 24",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "019503872",
            "telephone_number": "978-462-1555",
            "fax_number": "978-462-1560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEACOAST MEDICAL ASSOCIATES, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2014-12-31",
        "status": "A",
        "authorized_official_last_name": "MACDONALD",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "978-462-1555"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "153766",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "M15982",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IND MEDICARE PROVIDER NUM",
            "identifier": "A30492",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9773649",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newburyport, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.