Individual provider Active NPI

Kenneth Ray McCarthy, PA-C

  • Physician Assistant
  • Boston, MA
National Provider Identifier
1477126738
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA8235 Issued in MA
Practice address
55 Fruit St
Boston, MA 02114-2621
Phone
(617) 726-9111
NPI assigned
Jul 22, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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
Physician Assistant 363A00000X PA8235 MA Primary

Addresses

Primary practice location

55 Fruit St
Boston, MA 02114-2621

Mailing address

40 Florida Rd
Somers, CT 06071-1665
Phone (860) 707-5048

Other practice location 1

40 Florida Rd
Somers, CT 06071-1665
Phone (860) 707-5048

Other practice location 2

41 Burlington Mall Road
Burlington, MA 01805-1665
Phone (781) 744-5100

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
I20211108000270 MA Practitioner - Physician Assistant 5597154880 Reassigns benefits to 4 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA8235MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Massachusetts General Physicians Organization Inc CurrentSince Nov 23, 2023 Accepting new patients
General Hospital Corp Current Accepting new patients
Lahey Clinic, Inc CurrentSince Nov 2, 2021 Accepting new patients
Lahey Clinic, Inc. CurrentSince Nov 2, 2021 Accepting new patients

Locations

55 Fruit St
#2
Boston, MA 02114
Phone (617) 726-2967

55 Fruit St
Boston, MA 02114

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

Interoperability endpoints

  • Direct secure messaging: mccarthy.kenneth.mgh@direct.partners.masshiway.net

Organizations & group practices 5

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": "1626912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700438400000",
    "number": "1477126738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 FLORIDA RD",
            "city": "SOMERS",
            "state": "CT",
            "postal_code": "060711665",
            "telephone_number": "860-707-5048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 FRUIT ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021142621",
            "telephone_number": "617-726-9111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 Florida Rd",
            "address_purpose": "LOCATION",
            "city": "Somers",
            "state": "CT",
            "postal_code": "060711665",
            "country_code": "US",
            "telephone_number": "860-707-5048",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "41 Burlington Mall Road",
            "address_purpose": "LOCATION",
            "city": "Burlington",
            "state": "MA",
            "postal_code": "018051665",
            "country_code": "US",
            "telephone_number": "781-744-5100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "KENNETH",
        "middle_name": "RAY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-22",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA8235",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.