NPIMap

Individual provider Active NPI

Michael Gunson

  • Physician Assistant
  • Johnston, RI
National Provider Identifier
1013528199
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01266 Issued in RI
Practice address
11 Commerce Way Ste 5
Johnston, RI 02919-4613
Phone
(401) 606-2610
NPI assigned
Aug 12, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X PA01266 RI
Physician Assistant 363A00000X PA01266 RI Primary

Addresses

Primary practice location

11 Commerce Way Ste 5
Johnston, RI 02919-4613

Mailing address

1130 Ten Rod Rd Ste E305
North Kingstown, RI 02852-4176

Other practice location 1

345 Blackstone Blvd
Providence, RI 02906-4800
Phone (401) 455-6346

Other practice location 2

1130 Ten Rod Rd Ste E305
North Kingstown, RI 02852-4176
Phone (401) 294-0451

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201116002864 RI Practitioner - Physician Assistant 9830500289 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University Otolaryngology-Head and Neck Surgery, Inc.Group PAC ID 3274613930, 19 clinicians

Practice addresses (Care Compare)

1351 S County TRL
East Greenwich, RI 02818-5083

830 Eddy St
Providence, RI 02905-4810
Phone (401) 885-8484

Hospital & facility affiliations

  • Rhode Island Hospital Hospital, Providence, RI, CCN 410007
  • The Miriam Hospital Hospital, Providence, RI, CCN 410012
  • Newport Hospital Hospital, Newport, RI, CCN 410006

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as group
Quality
0
Promoting interoperability
0
Improvement activities
0
Cost
0

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA01266RIMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Otolaryngology Head & Neck Surgery Inc. Past Accepting new patients

Organizations & group practices 2

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 6

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": "1597190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1013528199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1130 TEN ROD RD STE E305",
            "city": "NORTH KINGSTOWN",
            "state": "RI",
            "postal_code": "028524176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 COMMERCE WAY STE 5",
            "city": "JOHNSTON",
            "state": "RI",
            "postal_code": "029194613",
            "telephone_number": "401-606-2610"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "345 Blackstone Blvd",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "RI",
            "postal_code": "029064800",
            "country_code": "US",
            "telephone_number": "401-455-6346",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1130 Ten Rod Rd Ste E305",
            "address_purpose": "LOCATION",
            "city": "North Kingstown",
            "state": "RI",
            "postal_code": "028524176",
            "country_code": "US",
            "telephone_number": "401-294-0451",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GUNSON",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-12",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "RI",
            "license": "PA01266",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnston, RI

Sources for this page

Verify at the official NPI Registry.