Individual provider Active NPI

Kyle Linehan

  • Physician Assistant
  • Plymouth, MA
National Provider Identifier
1306371463
Registry record updated Feb 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA6077 Issued in MA
Practice address
30 Aldrin Rd
Plymouth, MA 02360-4804
Phone
(508) 746-8977
NPI assigned
Apr 26, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA6077 MA Primary

Addresses

Primary practice location

30 Aldrin Rd
Plymouth, MA 02360-4804

Mailing address

30 Aldrin Rd
Plymouth, MA 02360-4804
Phone (508) 746-8977

Other practice location 1

104 Park St
Hyannis, MA 02601-5206
Phone (508) 746-8977

Other practice location 2

544 Main St
Weymouth, MA 02190-1818
Phone (508) 746-8977

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
I20170809004202 MA Practitioner - Physician Assistant 1254602261 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bernard J Durante MD PCGroup PAC ID 3577539410, 16 clinicians

Practice addresses (Care Compare)

1 County Rd
Bourne, MA 02532-3756
Phone (508) 746-8977

30 Aldrin Rd
Plymouth, MA 02360-4804
Phone (508) 746-8977

Hospital & facility affiliations

  • Beth Israel Deaconess Hospital Plymouth Hospital, Plymouth, MA, CCN 220060
  • South Shore Hospital Hospital, South Weymouth, MA, CCN 220100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA6077MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Bernard J Durante MD PC CurrentSince May 31, 2017 Accepting new patients
Bernard J. Durante,MD,PC CurrentSince May 31, 2017 Accepting new patients

Locations

104 Park St
Hyannis, MA 02601
Phone (508) 746-8977

30 Aldrin Rd
Plymouth, MA 02360
Phone (508) 746-8977

544 Main St
Weymouth, MA 02190
Phone (508) 746-8977

Interoperability endpoints

  • Direct secure messaging: klinehan252885@direct.bilh.masshiway.net

Organizations & group practices 3

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 2

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": "1493164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1548979200000",
    "number": "1306371463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 ALDRIN RD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023604804",
            "telephone_number": "508-746-8977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 ALDRIN RD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023604804",
            "telephone_number": "508-746-8977"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 Park St",
            "address_purpose": "LOCATION",
            "city": "Hyannis",
            "state": "MA",
            "postal_code": "026015206",
            "country_code": "US",
            "telephone_number": "508-746-8977",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "544 Main St",
            "address_purpose": "LOCATION",
            "city": "Weymouth",
            "state": "MA",
            "postal_code": "021901818",
            "country_code": "US",
            "telephone_number": "508-746-8977",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LINEHAN",
        "first_name": "KYLE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-26",
        "last_updated": "2019-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA6077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.