Individual provider Active NPI

Keri Manca, PA-C

  • Physician Assistant
  • Concord, MA
National Provider Identifier
1083110266
Registry record updated Jul 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA6991 Issued in MA
Practice address
133 Old Road to 9 Acre Cor
Concord, MA 01742-4169
Phone
(978) 369-3160
NPI assigned
Apr 5, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 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 PA6991 MA Primary

Addresses

Primary practice location

133 Old Road to 9 Acre Cor
Concord, MA 01742-4169

Mailing address

133 Old Road to 9 Acre Cor
Concord, MA 01742-4169
Phone (978) 369-3160

Other names 1

  • Keri Foley Former name

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
I20190607000859 MA Practitioner - Physician Assistant 7214291152 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Tufts University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emerson Practice Associates, IncGroup PAC ID 8123188117, 247 clinicians

Practice addresses (Care Compare)

133 Old Rd to 9 Acre Cor
Concord, MA 01742-4159
Phone (978) 287-3020

133 Old Rd to Nine Acre Corner
Mary Beth Misserville
Concord, MA 01742-4159

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1353NHMDPediatric Occupational Therapist
PA6991MAMDPhysician Assistant

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 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": "1522886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658880000000",
    "number": "1083110266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 OLD ROAD TO 9 ACRE COR",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017424169",
            "telephone_number": "978-369-3160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 OLD ROAD TO 9 ACRE COR",
            "city": "CONCORD",
            "state": "MA",
            "postal_code": "017424169",
            "telephone_number": "978-369-3160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANCA",
        "first_name": "KERI",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-05",
        "last_updated": "2022-07-27",
        "certification_date": "2022-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA6991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KERI",
            "last_name": "FOLEY",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Concord, MA

Sources for this page

Verify at the official NPI Registry.