Individual provider Active NPI

Marygrace Hegarty, PA-C

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1013471390
Registry record updated Oct 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA060374 Issued in PA
Practice address
800 Spruce Street
Pine 1 West
Philadelphia, PA 19107-6130
Phone
(215) 829-7817
Fax
(215) 829-7129
NPI assigned
Jan 30, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA060374 PA Primary

Addresses

Primary practice location

800 Spruce Street
Pine 1 West
Philadelphia, PA 19107-6130

Mailing address

800 Spruce Street
Pine 1 West
Philadelphia, PA 19107-6130
Phone (215) 829-7817

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210624001838 PA Practitioner - Physician Assistant 2163823402 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clinical Care Associates of the University of Pennsylvania Health.Group PAC ID 4688588866, 591 clinicians

Practice addresses (Care Compare)

777 Township Line Rd
Suite 200
Yardley, PA 19067-5564
Phone (215) 860-0775

800 Spruce St FL 1 Pine W
Hospital Medicine Pah
Philadelphia, PA 19107-6130
Phone (215) 829-7817

Hospital & facility affiliations

  • Pennsylvania Hospital Hospital, Philadelphia, PA, CCN 390226

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA060374PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University of Penn-Medical Group CurrentSince Oct 1, 2021 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health CurrentSince Aug 16, 2021 Accepting new patients
University of Penn-Medical Group CurrentSince Oct 1, 2021 Accepting new patients
Clinical Care Associates of the University of Pennsylvania Health Syst PastSince Oct 30, 2022 Accepting new patients

Locations

3400 Civic Center Blvd
#2
Philadelphia, PA 19104
Phone (215) 615-0063

800 Spruce St
#1W
Philadelphia, PA 19107
Phone (215) 829-7817

800 Spruce St
William Penn Annex West, PA 19107
Phone (215) 829-3867

777 Township Line Rd
Ste 200
Yardley, PA 19067
Phone (215) 860-0775

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1548806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666915200000",
    "number": "1013471390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 SPRUCE STREET",
            "address_2": "PINE 1 WEST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076130",
            "telephone_number": "215-829-7817",
            "fax_number": "215-829-7129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 SPRUCE STREET",
            "address_2": "PINE 1 WEST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191076130",
            "telephone_number": "215-829-7817",
            "fax_number": "215-829-7129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEGARTY",
        "first_name": "MARYGRACE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-30",
        "last_updated": "2022-10-28",
        "certification_date": "2022-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA060374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.