Individual provider Active NPI

Gregory Jude Poirier, PA

  • Physician Assistant
  • Stoneham, MA
National Provider Identifier
1124100649
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA2568 Issued in MA
Practice address
3 Woodland Rd
Suite 216
Stoneham, MA 02180-1702
Phone
(781) 979-0661
Fax
(781) 979-0372
NPI assigned
Oct 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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 PA2568 MA Primary

Addresses

Primary practice location

3 Woodland Rd
Suite 216
Stoneham, MA 02180-1702

Mailing address

3 Woodland Rd
Suite 216
Stoneham, MA 02180-1702
Phone (781) 979-0661

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20210408001318 CA Practitioner - Physician Assistant 2668577651 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Genesis Healthcare Partners PCGroup PAC ID 2163606807, 232 clinicians

Practice addresses (Care Compare)

23600 Telo Ave
Suite 220
Torrance, CA 90505-4039
Phone (310) 534-8400

Hospital & facility affiliations

  • Torrance Memorial Medical Center Hospital, Torrance, CA, CCN 050351

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3584AZMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Urology Institute of the South Bay Current Accepting new patients
Winchester Physician Associates Past Accepting new patients
Tucson Orthopaedic Institute Professional Corporation Physician Assistant Past Accepting new patients

Locations

23600 Telo Ave
Ste 220
Torrance, CA 90505
Phone (310) 534-8400

Interoperability endpoints

  • Direct secure messaging: gregory.poirier.1@3663.direct.athenahealth.com

Organizations & group practices 5

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1124100649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 WOODLAND RD",
            "address_2": "SUITE 216",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021801702",
            "telephone_number": "781-979-0661",
            "fax_number": "781-979-0372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 WOODLAND RD",
            "address_2": "SUITE 216",
            "city": "STONEHAM",
            "state": "MA",
            "postal_code": "021801702",
            "telephone_number": "781-979-0661",
            "fax_number": "781-979-0372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POIRIER",
        "first_name": "GREGORY",
        "middle_name": "JUDE",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA2568",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stoneham, MA

Sources for this page

Verify at the official NPI Registry.