Individual provider Active NPI

Christopher R Cannell, P.A.

  • Physician Assistant
  • Norwell, MA
National Provider Identifier
1386692515
Registry record updated Jun 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1636 Issued in MA
Practice address
75 Washington St
Norwell, MA 02061-1795
Phone
(781) 878-5200
Fax
(781) 331-1763
NPI assigned
May 4, 2006
Last updated
Jun 22, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 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 1636 MA Primary

Addresses

Primary practice location

75 Washington St
Norwell, MA 02061-1795

Mailing address

75 Washington Street
Norwell, MA 02061-9147
Phone (781) 878-5200

Other identifiers 5

IdentifierTypeStateIssuer
PTAN AP203001OtherMAMEDICARE
042297845OtherPHCS/MULTI-PLAN
042297845OtherGREAT WEST
042297845OtherTRICARE
042297845OtherFALLON

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
I20040113000567 MA Practitioner - Physician Assistant 0648170787 Reassigns benefits to 9 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coastal Medical AssociatesGroup PAC ID 7113029257, 443 clinicians

Practice addresses (Care Compare)

55 Fogg Rd
Weymouth, MA 02190-2432
Phone (781) 792-4136

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.65 of 100Reported as group
Quality
88.12
Promoting interoperability
71
Improvement activities
40
Cost
77.69

Merit-based Incentive Payment System (MIPS)

Final score
76.46 of 100Reported as group
Quality
72.66
Promoting interoperability
92
Improvement activities
40
Cost
55.55

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1636MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
South Shore Health Express, Inc CurrentSince Nov 1, 2018 Accepting new patients
Dana-Farber Cancer Institute, Inc. CurrentSince Dec 1, 2022 Accepting new patients
South Shore Health Express, Inc CurrentSince Nov 1, 2018 Accepting new patients
South Shore Orthopedics LLC CurrentSince Jun 1, 2023 Accepting new patients
South Shore Medical Center, Inc Past Accepting new patients
Bay Radiology Associates, Inc. Past Accepting new patients

Locations

450 Brookline Ave
Boston, MA 02215
Phone (508) 478-2061

2 Pond Park Rd
Ste 102
Hingham, MA 02043
Phone (781) 337-5555

117 Old Church St
Pembroke, MA 02359
Phone (781) 626-5170

55 Fogg Rd
Weymouth, MA 02190
Phone (781) 340-4293

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

Hospital & facility affiliations 1

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": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245628800000",
    "number": "1386692515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 WASHINGTON STREET",
            "city": "NORWELL",
            "state": "MA",
            "postal_code": "020619147",
            "telephone_number": "781-878-5200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 WASHINGTON ST",
            "city": "NORWELL",
            "state": "MA",
            "postal_code": "020611795",
            "telephone_number": "781-878-5200",
            "fax_number": "781-331-1763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANNELL",
        "first_name": "CHRISTOPHER",
        "middle_name": "R",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2009-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "1636",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "PTAN AP203001",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHCS/MULTI-PLAN",
            "identifier": "042297845",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT WEST",
            "identifier": "042297845",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "042297845",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FALLON",
            "identifier": "042297845",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwell, MA

Sources for this page

Verify at the official NPI Registry.