Individual provider Active NPI

Laurieann Quiry, PHYSICIAN ASSISTANT

  • Surgical Physician Assistant
  • Pittsfield, MA
National Provider Identifier
1356823694
Registry record updated Sep 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA6739 Issued in MA
Practice address
725 North St
Pittsfield, MA 01201-4124
Phone
(413) 447-2000
NPI assigned
Sep 4, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA6739 MA Primary

Addresses

Primary practice location

725 North St
Pittsfield, MA 01201-4124

Mailing address

725 North St
Pittsfield, MA 01201-4124
Phone (413) 447-2000

Other identifiers 1

IdentifierTypeStateIssuer
PA6739OtherMAMASSACHUSETTS BOARD OF PHYSICIAN ASSISTANTS

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
I20201027001544 MA Practitioner - Physician Assistant 1052721347 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA6739MAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Fairview Hospital CurrentSince Sep 28, 2020 Accepting new patients

Locations

780 S Main St
Ste 2
Gt Barrington, MA 01230
Phone (413) 447-2498

725 North St
Pittsfield, MA 01201
Phone (413) 447-2839

Interoperability endpoints

  • Direct secure messaging: laurieannquiry@bfs.medalliesdirect.net

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": "1536019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536019200000",
    "number": "1356823694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 NORTH ST",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014124",
            "telephone_number": "413-447-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 NORTH ST",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012014124",
            "telephone_number": "413-447-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUIRY",
        "first_name": "LAURIEANN",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-04",
        "last_updated": "2018-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "PA6739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASSACHUSETTS BOARD OF PHYSICIAN ASSISTANTS",
            "identifier": "PA6739",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsfield, MA

Sources for this page

Verify at the official NPI Registry.