Michael John Gillis, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA5093 Issued in MA

Practice address

230 Main St
Agawam, MA 01001-1838

Phone

(413) 789-6800

NPI assigned

Jul 15, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Riverbend Medical Group IncGroup PAC ID 5698064343, 227 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Medical Ctr Hospital, Springfield, MA, CCN 220066

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mgillis150271@direct.trinity-health.org

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.

• Riverbend Medical Group, Inc.

  dba Trinity Health Of New England Medical Group

  • Internal Medicine Physician
  • Springfield, MA
  • NPI 1841651197
  Medicare reassignment Care Compare group
• Riverbend Medical Group, Inc

  dba Trinity Health Of New England Medical Group

  • Durable Medical Equipment & Medical Supplies
  • Springfield, MA
  • NPI 1265023154
  NPD
• Mwa, PC

  dba RiverBend Medical Group

  • Sleep Disorder Diagnostic Clinic/Center
  • Chicopee, MA
  • NPI 1427280791
  NPD (past)
• Mwa,PC

  dba RiverBend Medical Group

  • Internal Medicine Physician
  • Chicopee, MA
  • NPI 1609821990
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• The Mercy Hospital Inc

  dba Mercy Medical Center

  • General Acute Care Hospital
  • Springfield, MA
  • NPI 1043204316
  Care Compare affiliation
• The Mercy Hospital Inc

  dba Mercy Rehabilitation Hospital

  • Rehabilitation Hospital Unit
  • Springfield, MA
  • NPI 1750360798
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405382400000",
    "number": "1487061016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 MAIN ST",
            "city": "AGAWAM",
            "state": "MA",
            "postal_code": "010011838",
            "telephone_number": "413-789-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 MAIN ST",
            "city": "AGAWAM",
            "state": "MA",
            "postal_code": "010011838",
            "telephone_number": "413-789-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIS",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-15",
        "last_updated": "2014-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA5093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Genesis Health Ventures of Massachusetts, Inc. (Heritage Woods)
• Genesis Health Ventures of Massachusetts, Inc. (Heritage Hall South)
• Genesis Rehab Services PC
• Geriatric Primary Care PC
• Debra Lee Germain, COTA
• Stephanie Girard
• Pamela Glemboski, RPH
• Thomas Gobeille, RPH
• Kathleen Goddard, PT
• Sybel Gonzalez

• Medical Physician Assistant in Agawam, MA
• Providers in Agawam, MA by specialty
• Medical Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.