Individual provider Active NPI

Michael David McCarthy, PA

  • Physician Assistant
  • Somerville, MA
National Provider Identifier
1477828382
Registry record updated Sep 29, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA07778 Issued in TX
Practice address
40 Holland St
Somerville, MA 02144-2705
Phone
(617) 629-6000
NPI assigned
Mar 12, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2015

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 PA07778 TX Primary

Addresses

Primary practice location

40 Holland St
Somerville, MA 02144-2705

Mailing address

40 Holland St
Somerville, MA 02144-2705
Phone (617) 629-6000

Other identifiers 1

IdentifierTypeStateIssuer
PA07778OtherTXTEXAS PHYSICIAN ASSISTANT BOARD

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
I20151204002303 MA Practitioner - Physician Assistant 6608022512 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atrius Health IncGroup PAC ID 4789588641, 1,214 clinicians

Practice addresses (Care Compare)

100 2ND Ave
Needham, MA 02494-2809
Phone (781) 726-4800

133 Brookline Ave
Boston, MA 02215-3904
Phone (617) 421-1000

Hospital & facility affiliations

  • Emerson Hospital - Hospital, W Concord, MA, CCN 220084

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA07778TXMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Atrius Health, Inc. CurrentSince Oct 1, 2015 Accepting new patients
Atrius Health, Inc. Physician Assistant CurrentSince Oct 1, 2015 Accepting new patients

Locations

147 Milk St
Boston, MA 02109
Phone (617) 421-2508

133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000

40 Holland St
Somerville, MA 02144
Phone (617) 629-6000

Interoperability endpoints

  • Direct secure messaging: mmccarthypac161912@direct.atrius.masshiway.net

Organizations & group practices 2

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.

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": "1331510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1443484800000",
    "number": "1477828382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 HOLLAND ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021442705",
            "telephone_number": "617-629-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 HOLLAND ST",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021442705",
            "telephone_number": "617-629-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCARTHY",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-12",
        "last_updated": "2015-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA07778",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TEXAS PHYSICIAN ASSISTANT BOARD",
            "identifier": "PA07778",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

Verify at the official NPI Registry.