Individual provider Active NPI

Melba Gussy C Quitayen, PA

  • Medical Physician Assistant
  • Nashua, NH
National Provider Identifier
1114294378
Registry record updated Jul 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
0862 Issued in NH
Practice address
22 Prospect St
Nashua, NH 03060-3924
Phone
(603) 883-1626
Fax
(603) 881-9914
NPI assigned
Nov 16, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 0862 NH Primary

Addresses

Primary practice location

22 Prospect St
Nashua, NH 03060-3924

Mailing address

22 Prospect St
Nashua, NH 03060-3924
Phone (603) 883-1626

Other identifiers 1

IdentifierTypeStateIssuer
3074422MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20120329000337 NH Practitioner - Physician Assistant 0941460968 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St. Joseph Hospital of Nashua NHGroup PAC ID 2062455611, 271 clinicians

Practice addresses (Care Compare)

172 Kinsley St
Nashua, NH 03060-3648
Phone (603) 884-5600

173 Daniel Webster Hwy
Nashua, NH 03060-5256
Phone (603) 891-4500

Hospital & facility affiliations

  • St Joseph Hospital Hospital, Nashua, NH, CCN 300011

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0862NHMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Joseph Hospital of Nashua NH CurrentSince Oct 28, 2024 Accepting new patients
Catholic Medical Center CurrentSince Aug 1, 2018 Accepting new patients
Catholic Medical Center CurrentSince Aug 1, 2018 Accepting new patients

Locations

208 Robinson Rd
Hudson, NH 03051
Phone (603) 577-3410

775 S Main St
Manchester, NH 03102
Phone (603) 625-6198

195 McGregor St
Ste 310
Manchester, NH 03102

4 Dobson Way
Merrimack, NH 03054
Phone (603) 424-4181

442 Nashua St
Milford, NH 03055
Phone (603) 673-3014

460 Amherst St
Nashua, NH 03063
Phone (603) 577-8400

172 Kinsley St
Nashua, NH 03060
Phone (603) 595-3926

173 Daniel Webster Hwy
Nashua, NH 03060
Phone (603) 891-4400

166 Kinsley St
Ste 101
Nashua, NH 03060
Phone (603) 881-7141

Interoperability endpoints

  • Direct secure messaging: mquitayen2724459@direct.bsmhealth.org

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.

Hospital & facility affiliations 2

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": "1321401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467676800000",
    "number": "1114294378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 PROSPECT ST",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030603924",
            "telephone_number": "603-883-1626",
            "fax_number": "603-881-9914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 PROSPECT ST",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030603924",
            "telephone_number": "603-883-1626",
            "fax_number": "603-881-9914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUITAYEN",
        "first_name": "MELBA",
        "middle_name": "GUSSY C",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-16",
        "last_updated": "2016-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NH",
            "license": "0862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3074422",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashua, NH

Sources for this page

Verify at the official NPI Registry.