Individual provider Active NPI

Michael Patrick Macdonald, NP

  • Primary Care Nurse Practitioner
  • Plymouth, MA
National Provider Identifier
1124597588
Registry record updated Nov 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
RN2312494 Issued in MA
Practice address
1 Bumps Pond Road
Plymouth, MA 02360
Phone
(508) 291-2441
NPI assigned
Nov 15, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X RN2312494 MA Primary

Addresses

Primary practice location

1 Bumps Pond Road
Plymouth, MA 02360

Mailing address

11 Gibbens St
Weymouth, MA 02188-2608
Phone (781) 858-5578

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
I20191127000340 MA Practitioner - Nurse Practitioner 4082047394

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

21 School St
Suite 1
Quincy, MA 02169-6698

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Elm Tree Clinic, LLC CurrentSince Nov 1, 2019 Accepting new patients

Locations

12 Wood St
Ste 2
Lowell, MA 01851
Phone (978) 341-4144

21 School St
Ste 1
Quincy, MA 02169
Phone (617) 302-3343

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/19377/brand/1/csg/1/fhir/r4
  • Direct secure messaging: michael.macdonald.1@19377.direct.athenahealth.com

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542240000000",
    "number": "1124597588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 GIBBENS ST",
            "city": "WEYMOUTH",
            "state": "MA",
            "postal_code": "021882608",
            "telephone_number": "781-858-5578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 BUMPS POND ROAD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "02360",
            "telephone_number": "508-291-2441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "MICHAEL",
        "middle_name": "PATRICK",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-15",
        "last_updated": "2018-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MA",
            "license": "RN2312494",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.