Active NPI
Donna Marie Kentley, PA
- Physician Assistant
- Southbridge, MA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- PA5624
- Practice address
- 55 Sayles St
Southbridge, MA 01550-1729 - Phone
- (508) 764-2400
- Fax
- (508) 909-7770
- NPI assigned
- Jan 22, 2007
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA5624 | MA | Primary |
Addresses
Primary practice location
55 Sayles St
Southbridge, MA 01550-1729
Mailing address
PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110118960A | Medicaid | MA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
10 N Main St
Charlton, MA 01507-1590
Phone (508) 248-3015
100 S St
Southbridge, MA 01550-4051
Phone (508) 765-9771
55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000
55 Sayles St
Southbridge, MA 01550-1729
Phone (508) 764-2400
79 Sayles St
Southbridge, MA 01550-1729
Phone (508) 764-6041
Hospital & facility affiliations
- Umass Memorial Health - Harrington Hospital
- Umass Memorial Medical Center/University Campus
Merit-based Incentive Payment System (MIPS)
- Final score
- 100 of 100
- Quality
- 82.98
- Promoting interoperability
- 100
- Improvement activities
- 40
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA5624 | MA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Umass Memorial Medical Group, Inc. | Current | Accepting new patients |
Locations
55 Sayles St
Southbridge, MA 01550
Phone (508) 764-2400
100 South St
Southbridge, MA 01550
Phone (508) 764-8012
55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862
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.
-
- Internal Medicine Physician
- Worcester, MA
- NPI 1760445373
-
- General Acute Care Hospital
- Southbridge, MA
- NPI 1790780047
-
- Urgent Care Clinic/Center
- Oxford, MA
- NPI 1982381018
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Southbridge, MA
- NPI 1790780047
-
- General Acute Care Hospital
- Worcester, MA
- NPI 1831151455
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732147200000",
"number": "1356495907",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 415348",
"city": "BOSTON",
"state": "MA",
"postal_code": "022415348",
"telephone_number": "800-225-8885",
"fax_number": "508-764-2432"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 SAYLES ST",
"city": "SOUTHBRIDGE",
"state": "MA",
"postal_code": "015501729",
"telephone_number": "508-764-2400",
"fax_number": "508-909-7770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENTLEY",
"first_name": "DONNA",
"middle_name": "MARIE",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-22",
"last_updated": "2024-11-21",
"certification_date": "2024-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MA",
"license": "PA5624",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "110118960A",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Southbridge, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.