Individual provider Active NPI

John Paul Livingstone, PA-C

  • Physician Assistant
  • Bedford, MA
National Provider Identifier
1437649647
Registry record updated Jul 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA8005 Issued in MA
Practice address
154 Great Rd
Bedford, MA 01730-2725
Phone
(781) 430-8161
Fax
(781) 430-8191
NPI assigned
May 14, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 3570 TN
Physician Assistant 363A00000X PA8005 MA Primary

Addresses

Primary practice location

154 Great Rd
Bedford, MA 01730-2725

Mailing address

154 Great Rd
Bedford, MA 01730-2725
Phone (781) 430-8161

Other identifiers 2

IdentifierTypeStateIssuer
3570OtherTNTN PA LICENSE NUMBER
PA8005OtherMAMA PA LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20180921002931 TN Practitioner - Physician Assistant 7517218019 Reassigns benefits to 1 organization
I20210511000439 MA Practitioner - Physician Assistant 7517218019 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Tufts University School of Medicine, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1030 Main St
Waltham, MA 02451-7447
Phone (781) 894-6900

1210 Boylston St
Chestnut Hill, MA 02467-2109
Phone (774) 400-4084

16 Main St
Stoneham, MA 02180-3334
Phone (781) 279-4000

17 White St
Cambridge, MA 02140-1413
Phone (781) 430-9161

4110 Mystic Valley Pkwy
Suite 2
Medford, MA 02155-6916
Phone (774) 400-4084

648 Old W Central St
Franklin, MA 02038-3826
Phone (774) 400-4084

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Patriot Urgent Care Professionals PC CurrentSince Jun 1, 2021 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince May 11, 2018 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince May 11, 2018 Accepting new patients
Patriot Urgent Care Professionals PC CurrentSince Jun 1, 2021 Accepting new patients
Memphis Urgent Care #2, LLC. PastSince Feb 14, 2021 Accepting new patients

Locations

154 Great Rd
Bedford, MA 01730
Phone (781) 430-8161

1030 Main St
Waltham, MA 02451
Phone (781) 894-6900

8188 US Highway 51 N
Millington, TN 38053
Phone (901) 614-4455

Organizations & group practices 6

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": "1526256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658707200000",
    "number": "1437649647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "154 GREAT RD",
            "city": "BEDFORD",
            "state": "MA",
            "postal_code": "017302725",
            "telephone_number": "781-430-8161",
            "fax_number": "781-430-8191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "154 GREAT RD",
            "city": "BEDFORD",
            "state": "MA",
            "postal_code": "017302725",
            "telephone_number": "781-430-8161",
            "fax_number": "781-430-8191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVINGSTONE",
        "first_name": "JOHN",
        "middle_name": "PAUL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-14",
        "last_updated": "2022-07-25",
        "certification_date": "2022-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "3570",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA8005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TN PA LICENSE NUMBER",
            "identifier": "3570",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MA PA LICENSE NUMBER",
            "identifier": "PA8005",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford, MA

Sources for this page

Verify at the official NPI Registry.