Active NPI
Gannon McGrath
- Surgery Physician
- Brighton, MA
National Provider Identifier
1275193427
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- 280854
- Practice address
- 736 Cambridge St
Brighton, MA 02135-2907 - Phone
- (651) 789-3000
- NPI assigned
- Jun 19, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Surgery Physician | 208600000X | 280854 | MA | Primary |
Addresses
Primary practice location
736 Cambridge St
Brighton, MA 02135-2907
Mailing address
170 Parker Hill Ave Apt 5
Boston, MA 02120-2855
Phone (320) 237-0038
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: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190820002786 | MA | Order and Referring Only - General Surgery | 6901134675 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Interoperability endpoints
- gmcgrath259865@direct.bmc.masshiway.net
- gannon.mcgrath.1@2017.direct.athenahealth.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1560902400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1560902400000",
"number": "1275193427",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "170 PARKER HILL AVE APT 5",
"city": "BOSTON",
"state": "MA",
"postal_code": "021202855",
"telephone_number": "320-237-0038"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "736 CAMBRIDGE ST",
"city": "BRIGHTON",
"state": "MA",
"postal_code": "021352907",
"telephone_number": "651-789-3000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCGRATH",
"first_name": "GANNON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-19",
"last_updated": "2019-06-19",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "MA",
"license": "280854",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brighton, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.