Individual provider Active NPI

Hannah Kullberg, PA-C

  • Physician Assistant
  • Westford, MA
National Provider Identifier
1184421356
Registry record updated Feb 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
12 Tadmuck LN
Westford, MA 01886-2017
Phone
(978) 320-1994
NPI assigned
Feb 26, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 26, 2025

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 Primary

Addresses

Primary practice location

12 Tadmuck LN
Westford, MA 01886-2017

Mailing address

12 Tadmuck LN
Westford, MA 01886-2017
Phone (978) 320-1994

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
I20250602002277 MA Practitioner - Physician Assistant 6800305822 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Outer Cape Health Services IncGroup PAC ID 4385554971, 51 clinicians

Practice addresses (Care Compare)

3130 State Hwy Rte 6
Wellfleet, MA 02667-7402
Phone (508) 349-3131

49 Harry Kemp Way
Provincetown, MA 02657-1618
Phone (508) 487-9395

710 Route 28
Harwich Port, MA 02646-1931
Phone (508) 432-1400

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Outer Cape Health Services CurrentSince Jul 14, 2025 Accepting new patients
Outer Cape Health Services, Inc. Past Accepting new patients

Locations

49 Harry Kemp Way
Provincetown, MA 02657
Phone (508) 487-9395

3130 State Hwy Rte 6
Wellfleet, MA 02667
Phone (508) 349-3131

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 2

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": "1740528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740528000000",
    "number": "1184421356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 TADMUCK LN",
            "city": "WESTFORD",
            "state": "MA",
            "postal_code": "018862017",
            "telephone_number": "978-320-1994"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 TADMUCK LN",
            "city": "WESTFORD",
            "state": "MA",
            "postal_code": "018862017",
            "telephone_number": "978-320-1994"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULLBERG",
        "first_name": "HANNAH",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-26",
        "last_updated": "2025-02-26",
        "certification_date": "2025-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westford, MA

Sources for this page

Verify at the official NPI Registry.