Individual provider Active NPI

Michael S Ruggiero, PA

  • Medical Physician Assistant
  • Peabody, MA
National Provider Identifier
1275598112
Registry record updated Apr 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1733 Issued in MA
Practice address
2 Essex Center Dr
Peabody, MA 01960-2902
Phone
(978) 977-4000
NPI assigned
Apr 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1733 MA
Medical Physician Assistant 363AM0700X 1733 MA Primary

Addresses

Primary practice location

2 Essex Center Dr
Peabody, MA 01960-2902

Mailing address

147 Milk St
Provider Enrollment - 9TH Floor
Boston, MA 02109-4806
Phone (617) 559-8053

Other practice location 1

210 Andover St
Peabody, MA 01960-1647
Phone (978) 488-3234

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
I20051018001045 MA Practitioner - Physician Assistant 7517983620 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Convenientmd - FFS UC LLCGroup PAC ID 5193186492, 397 clinicians

Practice addresses (Care Compare)

180 Main St
Saugus, MA 01906-4502
Phone (339) 674-0978

236 Cochituate Rd
Framingham, MA 01701-4627
Phone (774) 244-3227

245 Hartford Ave
Bellingham, MA 02019-3007
Phone (774) 295-4355

40 Davis Straits
Falmouth, MA 02540-3906
Phone (774) 255-3010

70 Gold Star Blvd
Worcester, MA 01606-2812
Phone (508) 426-9002

86 Taunton St
Plainville, MA 02762-2131
Phone (508) 928-5211

999 Dalton Ave
Pittsfield, MA 01201-2903
Phone (413) 242-6577

Merit-based Incentive Payment System (MIPS)

Final score
73.71 of 100Reported as group
Quality
56.09
Improvement activities
40
Cost
79.16

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1733MAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Afc Physicians of Massachusetts, PC CurrentSince Mar 1, 2023 Accepting new patients
Mass General Brigham Urgent Care LLC CurrentSince Feb 5, 2020 Accepting new patients
Mass General Brigham Urgent Care LLC CurrentSince Feb 5, 2020 Accepting new patients
Convenientmd - FFS UC LLC CurrentSince Apr 1, 2024 Accepting new patients
Convenientmd - FFS UC LLC CurrentSince Apr 1, 2024 Accepting new patients

Locations

245 Hartford Ave
Bellingham, MA 02019
Phone (774) 295-4355

1285 Beacon St
Brookline, MA 02446
Phone (617) 751-6205

40 Davis Straits
Falmouth, MA 02540
Phone (774) 255-3010

210 Andover St
Peabody, MA 01960
Phone (978) 278-7400

415 Cooley St
Unit 3
Springfield, MA 01128
Phone (413) 782-4878

360 US Highway 1 Byp
Unit 102
Portsmouth, NH 03801
Phone (603) 410-6700

Interoperability endpoints

  • Direct secure messaging: michael.ruggiero.p27@direct.medcor.nextgenshare.com

Organizations & group practices 7

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": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712102400000",
    "number": "1275598112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "147 MILK ST",
            "address_2": "PROVIDER ENROLLMENT - 9TH FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021094806",
            "telephone_number": "617-559-8053",
            "fax_number": "617-421-3487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 ESSEX CENTER DR",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019602902",
            "telephone_number": "978-977-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "210 Andover St",
            "address_purpose": "LOCATION",
            "city": "Peabody",
            "state": "MA",
            "postal_code": "019601647",
            "country_code": "US",
            "telephone_number": "978-488-3234",
            "fax_number": "978-488-3235",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUGGIERO",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2024-04-03",
        "certification_date": "2024-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "1733",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "1733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

Verify at the official NPI Registry.