NPIMap

Individual provider Active NPI

Molly Ellen Naeger, PA-C

  • Physician Assistant
  • Winchester, MA
National Provider Identifier
1225504236
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA6750 Issued in MA
Practice address
41 Highland Ave
Winchester, MA 01890-1446
Phone
(315) 254-5770
NPI assigned
Oct 17, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X
Physician Assistant 363A00000X PA6750 MA Primary

Addresses

Primary practice location

41 Highland Ave
Winchester, MA 01890-1446

Mailing address

100 Waltham St Apt 2
Boston, MA 02118-3682
Phone (315) 254-5770

Other practice location 1

55 Fogg Rd
Weymouth, MA 02190-2432
Phone (781) 624-8000

Other identifiers 1

IdentifierTypeStateIssuer
PA6750OtherMAMA STATE LICENSE

Other names 1

  • Molly Ellen Winiecki Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address mwiniecki@southshorehealth.org Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181126001051 MA Practitioner - Physician Assistant 5092069310 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
91.27 of 100Reported as group
Quality
77.51
Promoting interoperability
100
Improvement activities
40
Cost
76.72

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA6750MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cambridge Public Health Commission CurrentSince Aug 14, 2023 Accepting new patients
Beth Israel Lahey Health Specialty Care, Inc. CurrentSince Dec 1, 2024 Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

103 Garland St
Everett, MA 02149
Phone (617) 381-7150

Organizations & group practices 8

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": "1539734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1225504236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 WALTHAM ST APT 2",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021183682",
            "telephone_number": "315-254-5770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "41 HIGHLAND AVE",
            "city": "WINCHESTER",
            "state": "MA",
            "postal_code": "018901446",
            "telephone_number": "315-254-5770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Fogg Rd",
            "address_purpose": "LOCATION",
            "city": "Weymouth",
            "state": "MA",
            "postal_code": "021902432",
            "country_code": "US",
            "telephone_number": "781-624-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAEGER",
        "first_name": "MOLLY",
        "middle_name": "ELLEN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-17",
        "last_updated": "2022-08-03",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA6750",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MA STATE LICENSE",
            "identifier": "PA6750",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mwiniecki@southshorehealth.org",
            "affiliation": "N",
            "endpointDescription": "Tiger",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "55 Fogg Rd",
            "city": "Weymouth",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021902432",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "WINIECKI",
            "middle_name": "ELLEN",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Winchester, MA

Sources for this page

Verify at the official NPI Registry.