Individual provider Active NPI

Gentry W Thatcher, MD

  • Otolaryngology Physician
  • N Andover, MA
National Provider Identifier
1124020730
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
204712 Issued in MA
Practice address
198 Massachusetts Ave #103
N Andover, MA 01845
Phone
(978) 685-7550
Fax
(978) 686-5565
NPI assigned
Aug 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 204712 MA Primary
Otolaryngology Physician 207Y00000X 11012 NH

Addresses

Primary practice location

198 Massachusetts Ave #103
N Andover, MA 01845

Mailing address

198 Massachusetts Ave #103
N Andover, MA 01845
Phone (978) 685-7550

Other identifiers 16

IdentifierTypeStateIssuer
2344337OtherAETNA/USHC
B20973001OtherCIGNA
0020548OtherNHP
01Y002475MA01OtherNH BS
204712OtherSECURE HORIZ
7439118-001OtherCIGNA PAL
76754OtherAAO/HNS
976854OtherNETWORK HEALTH
J22387OtherBS-HMO
10-00243OtherUNITED HC
J22387OtherBS/MA
0104914MedicaidMA
19901OtherH/PIL
65475OtherFALLON
040015652OtherMC RR
204712OtherTUFTS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20110106000139 MA Practitioner - Otolaryngology 3072677251 Reassigns benefits to 1 organization
I20140314001064 NH Practitioner - Otolaryngology 3072677251 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Tufts University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New England Ear Nose and Throat/Facial Plastic Surgery PCGroup PAC ID 8921192691, 16 clinicians

Practice addresses (Care Compare)

14 B Keewaydin Dr
Salem, NH 03079-2839
Phone (978) 685-7550

198 Massachusetts Ave
Suite 103
North Andover, MA 01845-4143
Phone (978) 685-7550

Hospital & facility affiliations

  • Holy Family Hospital Hospital, Methuen, MA, CCN 220080
  • Merrimack Health Lawrence Hospital Hospital, Lawrence, MA, CCN 220010
  • Parkland Medical Center Hospital, Derry, NH, CCN 300017
  • Anna Jaques Hospital Hospital, Newburyport, MA, CCN 220029

Merit-based Incentive Payment System (MIPS)

Final score
87.77 of 100Reported as individual
Quality
73.83
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Hearing Center LLC CurrentSince Feb 7, 2021 Accepting new patients

Locations

14B Keewaydin Dr
Salem, NH 03079
Phone (978) 685-7550

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 4

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": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1124020730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "198 MASSACHUSETTS AVE #103",
            "city": "N ANDOVER",
            "state": "MA",
            "postal_code": "01845",
            "telephone_number": "978-685-7550",
            "fax_number": "978-686-5565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "198 MASSACHUSETTS AVE #103",
            "city": "N ANDOVER",
            "state": "MA",
            "postal_code": "01845",
            "telephone_number": "978-685-7550",
            "fax_number": "978-686-5565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THATCHER",
        "first_name": "GENTRY",
        "middle_name": "W",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MA",
            "license": "204712",
            "primary": true
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "NH",
            "license": "11012",
            "primary": false
        }
    ],
    "identifiers": [
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        },
        {
            "code": "01",
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            "issuer": "CIGNA",
            "identifier": "B20973001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NHP",
            "identifier": "0020548",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NH BS",
            "identifier": "01Y002475MA01",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SECURE HORIZ",
            "identifier": "204712",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA PAL",
            "identifier": "7439118-001",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AAO/HNS",
            "identifier": "76754",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NETWORK HEALTH",
            "identifier": "976854",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS-HMO",
            "identifier": "J22387",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HC",
            "identifier": "10-00243",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS/MA",
            "identifier": "J22387",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0104914",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "H/PIL",
            "identifier": "19901",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "65475",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MC RR",
            "identifier": "040015652",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TUFTS",
            "identifier": "204712",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in N Andover, MA

Sources for this page

Verify at the official NPI Registry.