Individual provider Active NPI

Kevin Matthew Twombly, PA-C

  • Physician Assistant
  • Portsmouth, NH
National Provider Identifier
1245907666
Registry record updated Oct 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1793 Issued in NH
Practice address
14 Manchester SQ Ste 290
Portsmouth, NH 03801-7866
Phone
(603) 766-8500
NPI assigned
Aug 24, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine Physician 208VP0000X PENDING NH
Physician Assistant 363A00000X 1793 NH Primary

Addresses

Primary practice location

14 Manchester SQ Ste 290
Portsmouth, NH 03801-7866

Mailing address

14 Manchester SQ Ste 290
Portsmouth, NH 03801-7866
Phone (603) 766-8500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20211006003053 NH Practitioner - Physician Assistant 8921406893 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
May accept Medicare assignment
Group practices
Portsmouth Trauma and Surgical Care, LLCGroup PAC ID 7012375819, 16 clinicians

Practice addresses (Care Compare)

330 Borthwick Ave
Suite 308
Portsmouth, NH 03801-7112
Phone (603) 431-5242

333 Borthwick Ave
Portsmouth, NH 03801-7128
Phone (603) 436-5110

Hospital & facility affiliations

  • Portsmouth Regional Hospital Hospital, Portsmouth, NH, CCN 300029
  • Frisbie Memorial Hospital Hospital, Rochester, NH, CCN 300014
  • Parkland Medical Center Hospital, Derry, NH, CCN 300017

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PENDINGNHMDGeneral Practice Dentistry
1793NHMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Appledore Medical Group, Inc CurrentSince Feb 27, 2024 Accepting new patients
Appledore Medical Group Dba Woodbury Family Practice CurrentSince Feb 27, 2024 Accepting new patients

Locations

330 Borthwick Ave
Ste 308
Portsmouth, NH 03801
Phone (603) 431-5242

330 Borthwick Ave
Ste 201
Portsmouth, NH 03801
Phone (603) 431-5242

2000 Health Park Dr
Brentwood, TN 37027
Phone (615) 372-5426

Interoperability endpoints

  • Direct secure messaging: kevin.twombly@hca6.eclinicaldirectplus.com

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 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": "1629763200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633996800000",
    "number": "1245907666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14 MANCHESTER SQ STE 290",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017866",
            "telephone_number": "603-766-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14 MANCHESTER SQ STE 290",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017866",
            "telephone_number": "603-766-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TWOMBLY",
        "first_name": "KEVIN",
        "middle_name": "MATTHEW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-24",
        "last_updated": "2021-10-12",
        "certification_date": "2021-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0000X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Pain Medicine",
            "state": "NH",
            "license": "PENDING",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "1793",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, NH

Sources for this page

Verify at the official NPI Registry.