NPIMap

Individual provider Active NPI

Matthew Michael Kane, PAC

  • Physician Assistant
  • Plymouth, MA
National Provider Identifier
1114672987
Registry record updated Dec 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA8985 Issued in MA
Practice address
46 Obery St Ste 100
Plymouth, MA 02360-2237
Phone
(508) 210-5800
Fax
(508) 210-5860
NPI assigned
Feb 19, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Physician Assistant 363A00000X PA8985 MA Primary

Addresses

Primary practice location

46 Obery St Ste 100
Plymouth, MA 02360-2237

Mailing address

46 Obery St Ste 100
Plymouth, MA 02360-2237
Phone (508) 210-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230112001432 MA Practitioner - Physician Assistant 3779953542 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jordan Physician Associates IncGroup PAC ID 1254321086, 166 clinicians
Physiotherapy Associates IncGroup PAC ID 3577470442, 1,432 clinicians

Practice addresses (Care Compare)

275 Sandwich St
Plymouth, MA 02360-2183
Phone (508) 746-2000

3119 Cranberry Hwy
Suite 5
East Wareham, MA 02538-4840
Phone (508) 759-5411

46 Obery St
Plymouth, MA 02360-2237
Phone (508) 210-5920

860 Route 134
Suite 5And6
South Dennis, MA 02660-2577
Phone (508) 385-4212

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA8985MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Plymouth Bay Orthopedic Associates Inc. CurrentSince Feb 1, 2023 Accepting new patients
Jordan Physician Associates, Inc. CurrentSince Jun 1, 2024 Accepting new patients
Jordan Physician Associates, Inc. CurrentSince Jun 1, 2024 Accepting new patients

Locations

95 Tremont St
Ste 1
Duxbury, MA 02332
Phone (781) 934-2400

46 Obery St
Plymouth, MA 02360
Phone (508) 210-5920

41 Resnik Rd
Plymouth, MA 02360
Phone (781) 934-2400

46 Obery St
Ste 100
Plymouth, MA 02360
Phone (508) 746-0284

Interoperability endpoints

  • Direct secure messaging: mkane253123@direct.bilh.masshiway.net

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 8

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": "1645228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733097600000",
    "number": "1114672987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46 OBERY ST STE 100",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602237",
            "telephone_number": "508-210-5800",
            "fax_number": "508-210-5860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46 OBERY ST STE 100",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602237",
            "telephone_number": "508-210-5800",
            "fax_number": "508-210-5860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KANE",
        "first_name": "MATTHEW",
        "middle_name": "MICHAEL",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-19",
        "last_updated": "2024-12-02",
        "certification_date": "2024-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA8985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.