Individual provider Active NPI

Paige M Lovelace, PA-C

  • Physician Assistant
  • Providence, RI
National Provider Identifier
1285038562
Registry record updated Jan 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA Issued in MA
Practice address
1287 N Main St
Providence, RI 02904-1856
Phone
(401) 272-2724
Fax
(401) 272-2784
NPI assigned
Oct 15, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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 PA00923 RI
Physician Assistant 363A00000X PA MA Primary

Addresses

Primary practice location

1287 N Main St
Providence, RI 02904-1856

Mailing address

1805 NW Platte Rd Ste 120
Riverside, MO 64150-7500
Phone (816) 472-0400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190802002952 MO Practitioner - Physician Assistant 8022331677 Reassigns benefits to 1 organization
I20200618000732 KS Practitioner - Physician Assistant 8022331677 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kansas City Skin and Cancer Center LLCGroup PAC ID 5597858795, 15 clinicians

Practice addresses (Care Compare)

8656 N Ambassador Dr
Kansas City, MO 64154-2558
Phone (816) 584-8100

9301 W 74TH St
Suite 230
Shawnee Mission, KS 66204-2217
Phone (816) 584-8100

Merit-based Incentive Payment System (MIPS)

Final score
92.5 of 100Reported as group
Quality
85
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PAMAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Epiphany Dermatology of Missouri, LLC CurrentSince Nov 1, 2020 Accepting new patients

Locations

1805 NW Platte Rd
Ste 120
Riverside, MO 64150
Phone (816) 205-8120

805 N 36th St
Ste D
Saint Joseph, MO 64506
Phone (816) 205-8120

7300 Ranch Road 2222
Ste 200
Austin, TX 78730

Interoperability endpoints

  • Direct secure messaging: plandry@epiphanykc.emadirect.md

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1413331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579737600000",
    "number": "1285038562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 NW PLATTE RD STE 120",
            "city": "RIVERSIDE",
            "state": "MO",
            "postal_code": "641507500",
            "telephone_number": "816-472-0400",
            "fax_number": "816-472-0813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1287 N MAIN ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029041856",
            "telephone_number": "401-272-2724",
            "fax_number": "401-272-2784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOVELACE",
        "first_name": "PAIGE",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-15",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA00923",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.