Individual provider Active NPI

Holly T Nguyen, PAC

  • Medical Physician Assistant
  • Wilmington, MA
National Provider Identifier
1144236266
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1035 Issued in MA
Practice address
64 Concord St
Ste C
Wilmington, MA 01887
Phone
(978) 988-9700
Fax
(978) 988-9701
NPI assigned
Jul 31, 2006
Sex
Female
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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 1035 MA Primary

Addresses

Primary practice location

64 Concord St
Ste C
Wilmington, MA 01887

Mailing address

64 Concord St
Ste C
Wilmington, MA 01887
Phone (978) 988-9700

Other identifiers 3

IdentifierTypeStateIssuer
MN0377881JOtherMACONTROL LIC
1035OtherMALICENSE
043480187OtherTAX ID

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
I20070202000358 MA Practitioner - Physician Assistant 5395747448 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rheumatology and Internal Medicine Associates PCGroup PAC ID 2163465592, 3 clinicians

Practice addresses (Care Compare)

64 C Concord St
Wilmington, MA 01887-2179
Phone (978) 988-9700

Hospital & facility affiliations

  • Winchester Hospital Hospital, Winchester, MA, CCN 220105
  • Merrimack Health Lawrence Hospital Hospital, Lawrence, MA, CCN 220010
  • Lahey Hospital & Medical Center, Burlington Hospital, Burlington, MA, CCN 220171

Merit-based Incentive Payment System (MIPS)

Final score
82.58 of 100Reported as group
Quality
93.94
Promoting interoperability
93
Improvement activities
40
Cost
51.74

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1035MAMDMedical Physician Assistant

Interoperability endpoints

  • Direct secure messaging: hollynguyen@rimapc.allscriptsdirect.net

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.

Hospital & facility affiliations 3

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1144236266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 CONCORD ST",
            "address_2": "STE C",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "01887",
            "telephone_number": "978-988-9700",
            "fax_number": "978-988-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 CONCORD ST",
            "address_2": "STE C",
            "city": "WILMINGTON",
            "state": "MA",
            "postal_code": "01887",
            "telephone_number": "978-988-9700",
            "fax_number": "978-988-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "HOLLY",
        "middle_name": "T",
        "name_prefix": "Mrs.",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2023-03-07",
        "certification_date": "2020-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "1035",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROL LIC",
            "identifier": "MN0377881J",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "1035",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "043480187",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wilmington, MA

Sources for this page

Verify at the official NPI Registry.