Individual provider Active NPI

Karyn Elizabeth Macqueen, PA-C

  • Physician Assistant
  • Media, PA
National Provider Identifier
1376745836
Registry record updated Mar 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA052641 Issued in PA
Practice address
1068 W Baltimore Pike
Media, PA 19063-5104
Phone
(610) 891-3214
NPI assigned
Jun 5, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2009

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 MA052641 PA Primary

Addresses

Primary practice location

1068 W Baltimore Pike
Media, PA 19063-5104

Mailing address

224 Willits Way
RMH Emergency Medicine Physicians
Glen Mills, PA 19342-1458
Phone (610) 891-3214

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20080206000124 PA Practitioner - Physician Assistant 4688757222 Reassigns benefits to 2 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MA052641PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Emergency Care Services of Pennsylvania, P.C. Physician Assistant CurrentSince Sep 14, 2016 Accepting new patients

Locations

1201 Langhorne Newtown Rd
Penndel, PA 19047
Phone (215) 710-2100

2601 Holme Ave
Philadelphia, PA 19152
Phone (215) 335-6000

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.

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236297600000",
    "number": "1376745836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 WILLITS WAY",
            "address_2": "RMH EMERGENCY MEDICINE PHYSICIANS",
            "city": "GLEN MILLS",
            "state": "PA",
            "postal_code": "193421458",
            "telephone_number": "610-891-3214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1068 W BALTIMORE PIKE",
            "city": "MEDIA",
            "state": "PA",
            "postal_code": "190635104",
            "telephone_number": "610-891-3214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACQUEEN",
        "first_name": "KARYN",
        "middle_name": "ELIZABETH",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-05",
        "last_updated": "2009-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA052641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Media, PA

Sources for this page

Verify at the official NPI Registry.