Individual provider Active NPI

Sophy Em-McMenimon, P.A.-C

  • Physician Assistant
  • Paoli, PA
National Provider Identifier
1477712610
Registry record updated Sep 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
012385 Issued in NY
Practice address
255 W Lancaster Ave
Paoli Hospital- Emergency Department
Paoli, PA 19301-1763
Phone
(484) 565-1044
NPI assigned
Jun 3, 2008
Last updated
Sep 2, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2011

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 012385 NY Primary
Physician Assistant 363A00000X MA054812 PA

Addresses

Primary practice location

255 W Lancaster Ave
Paoli Hospital- Emergency Department
Paoli, PA 19301-1763

Mailing address

255 W Lancaster Ave
Paoli Hospital- Emergency Department
Paoli, PA 19301-1763
Phone (484) 565-1044

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
I20171113000901 MA Practitioner - Physician Assistant 0042386617 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
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

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
012385NYMDRegistered Dietitian

Organizations & group practices 1

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.

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": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1314921600000",
    "number": "1477712610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W LANCASTER AVE",
            "address_2": "PAOLI HOSPITAL- EMERGENCY DEPARTMENT",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011763",
            "telephone_number": "484-565-1044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 W LANCASTER AVE",
            "address_2": "PAOLI HOSPITAL- EMERGENCY DEPARTMENT",
            "city": "PAOLI",
            "state": "PA",
            "postal_code": "193011763",
            "telephone_number": "484-565-1044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EM-MCMENIMON",
        "first_name": "SOPHY",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-03",
        "last_updated": "2011-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "012385",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA054812",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paoli, PA

Sources for this page

Verify at the official NPI Registry.