Individual provider Active NPI

Mana C McClain, PA-C

  • Physician Assistant
  • Swampscott, MA
National Provider Identifier
1104418854
Registry record updated Dec 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA7932 Issued in MA
Practice address
990 Paradise Rd Ste 2B
Swampscott, MA 01907-1309
Phone
(781) 595-0151
Fax
(781) 592-6780
NPI assigned
Feb 4, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA-TF-0203 MA
Physician Assistant 363A00000X PA7932 MA Primary

Addresses

Primary practice location

990 Paradise Rd Ste 2B
Swampscott, MA 01907-1309

Mailing address

990 Paradise Rd Ste 2B
Swampscott, MA 01907-1309
Phone (781) 595-0151

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address Takeyama.Mana.HSGMD@direct.partners.masshiway.net Health Information Exchange (HIE)

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
I20210504000677 MA Practitioner - Physician Assistant 4486063674 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Howard S Goldberg MD IncGroup PAC ID 0244292688, 10 clinicians

Practice addresses (Care Compare)

990 Paradise Rd
Swampscott, MA 01907-1395
Phone 7815950151212

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA-TF-0203MAMDPhysician Assistant
PA7932MAMDPhysician Assistant

Interoperability endpoints

  • Direct secure messaging: takeyama.mana.hsgmd@direct.partners.masshiway.net

Organizations & group practices 1

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": "1612396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1104418854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 PARADISE RD STE 2B",
            "city": "SWAMPSCOTT",
            "state": "MA",
            "postal_code": "019071309",
            "telephone_number": "781-595-0151",
            "fax_number": "781-592-6780"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 PARADISE RD STE 2B",
            "city": "SWAMPSCOTT",
            "state": "MA",
            "postal_code": "019071309",
            "telephone_number": "781-595-0151",
            "fax_number": "781-592-6780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCLAIN",
        "first_name": "MANA",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-04",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA-TF-0203",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA7932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "Takeyama.Mana.HSGMD@direct.partners.masshiway.net",
            "affiliation": "N",
            "endpointDescription": "Howard S Goldberg MD Inc",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "HIE",
            "address_1": "990 Paradise Rd Ste 2B",
            "city": "Swampscott",
            "state": "MA",
            "country_code": "US",
            "postal_code": "019071309",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Swampscott, MA

Sources for this page

Verify at the official NPI Registry.