Individual provider Active NPI

Michael P McGlynn, PA

  • Physician Assistant
  • Melrose, MA
National Provider Identifier
1063592541
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
240 Issued in MA
Practice address
585 Lebanon St
Melrose, MA 02176-3225
Phone
(781) 937-4522
NPI assigned
Oct 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 240 MA Primary

Addresses

Primary practice location

585 Lebanon St
Melrose, MA 02176-3225

Mailing address

12 Gill St
Ste 3000
Woburn, MA 01801-1728
Phone (781) 937-4522

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
I20040915000323 MA Practitioner - Physician Assistant 6901873314 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
240MAMDHearing Instrument Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
Lawrence General Hospital CurrentSince Apr 4, 2015 Accepting new patients
Steward Medical Group, Inc. Past Accepting new patients
Caritas Medical Group, Inc Past Accepting new patients

Locations

1 General St
Lawrence, MA 01841
Phone (978) 946-8103

70 East St
Methuen, MA 01844
Phone (978) 682-1906

Organizations & group practices 3

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": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1063592541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 GILL ST",
            "address_2": "STE 3000",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011728",
            "telephone_number": "781-937-4522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 LEBANON ST",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "021763225",
            "telephone_number": "781-937-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGLYNN",
        "first_name": "MICHAEL",
        "middle_name": "P",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose, MA

Sources for this page

Verify at the official NPI Registry.