Individual provider Active NPI

Mary Ramsey Stuckey, PA-C

  • Medical Physician Assistant
  • Melrose, MA
National Provider Identifier
1164768792
Registry record updated Dec 31, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA4542 Issued in MA
Practice address
585 Lebanon St
Melrose, MA 02176-3225
Phone
(781) 979-3000
NPI assigned
Dec 31, 2012
Last updated
Dec 31, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 31, 2012

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 PA4542 MA Primary

Addresses

Primary practice location

585 Lebanon St
Melrose, MA 02176-3225

Mailing address

73 Haskell St
Beverly, MA 01915-2184
Phone (978) 973-7175

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
I20130927000479 MA Practitioner - Physician Assistant 0749414068 Reassigns benefits to 2 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Urgent Care Operations, PC CurrentSince Feb 1, 2020 Accepting new patients
Urgent Care Operations PC CurrentSince Feb 1, 2020 Accepting new patients

Locations

50 Dodge St
Ste 104
Beverly, MA 01915
Phone (978) 922-2171

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1356912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1356912000000",
    "number": "1164768792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "73 HASKELL ST",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019152184",
            "telephone_number": "978-973-7175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 LEBANON ST",
            "city": "MELROSE",
            "state": "MA",
            "postal_code": "021763225",
            "telephone_number": "781-979-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUCKEY",
        "first_name": "MARY",
        "middle_name": "RAMSEY",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-12-31",
        "last_updated": "2012-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA4542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melrose, MA

Sources for this page

Verify at the official NPI Registry.