Individual provider Active NPI

John W Nolan, PA

  • Physician Assistant
  • Falmouth, MA
National Provider Identifier
1013982875
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
872 Issued in MA
Practice address
100 Ter Heun Drive
Falmouth Hospital Emergency Department
Falmouth, MA 02540
Phone
(508) 457-3929
Fax
(508) 457-3839
NPI assigned
Feb 22, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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 872 MA Primary

Addresses

Primary practice location

100 Ter Heun Drive
Falmouth Hospital Emergency Department
Falmouth, MA 02540

Mailing address

1400 VFW Pkwy
West Roxbury, MA 02132-4927
Phone (781) 801-2168

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20080904000012 MA Practitioner - Physician Assistant 4789750498 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Steward Medical Group, Inc CurrentSince May 14, 2016 Accepting new patients
Steward Medical Group, Inc CurrentSince May 14, 2016 Accepting new patients
Steward Medical Group Inc. Past Accepting new patients
Bayside Emergency Medical Associates, P.C. Past Accepting new patients

Locations

77 Warren St
Fl 5
Brighton, MA 02135
Phone (617) 254-3376

11 Nevins St
Ste 201
Brighton, MA 02135
Phone (617) 789-2442

795 Middle St
Fall River, MA 02721
Phone (508) 235-5046

100 Amesbury St
Ste 103
Lawrence, MA 01840
Phone (978) 683-0157

40 Spring St
Watertown, MA 02472
Phone (617) 923-8433

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734566400000",
    "number": "1013982875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 VFW PKWY",
            "city": "WEST ROXBURY",
            "state": "MA",
            "postal_code": "021324927",
            "telephone_number": "781-801-2168",
            "fax_number": "774-826-2132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 TER HEUN DRIVE",
            "address_2": "FALMOUTH HOSPITAL EMERGENCY DEPARTMENT",
            "city": "FALMOUTH",
            "state": "MA",
            "postal_code": "02540",
            "telephone_number": "508-457-3929",
            "fax_number": "508-457-3839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLAN",
        "first_name": "JOHN",
        "middle_name": "W",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "872",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Falmouth, MA

Sources for this page

Verify at the official NPI Registry.