Active NPI
Linda B Cleary, PAC
- Physician Assistant
- Norwell, MA
National Provider Identifier
1508847559
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- MA587
- Practice address
- 99 Longwater Circle Suite 100
Norwell, MA 02061-1795 - Phone
- (781) 829-0930
- Fax
- (781) 829-8933
- NPI assigned
- Nov 8, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | MA587 | MA | Primary |
Addresses
Primary practice location
99 Longwater Circle Suite 100
Norwell, MA 02061-1795
Mailing address
99 Longwater Cir Ste 100
Norwell, MA 02061-1643
Phone (781) 829-0930
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 042297845 | Other | MA | DOC FIRST |
| 93477 | Other | MA | FALLON |
| 042297845 | Other | MA | TRICARE |
| AP2545 | Other | MA | MEDICARE |
| 042297845 | Other | MA | GREAT WEST HEALTH CARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
- Opted out of Medicare
- Yes, effective Oct 1, 2017 through Oct 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA587 | MA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1131408000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444694400000",
"number": "1508847559",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 LONGWATER CIR STE 100",
"city": "NORWELL",
"state": "MA",
"postal_code": "020611643",
"telephone_number": "781-829-0930",
"fax_number": "781-829-8933"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99 LONGWATER CIRCLE SUITE 100",
"city": "NORWELL",
"state": "MA",
"postal_code": "020611795",
"telephone_number": "781-829-0930",
"fax_number": "781-829-8933"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CLEARY",
"first_name": "LINDA",
"middle_name": "B",
"name_prefix": "Ms.",
"credential": "PAC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-08",
"last_updated": "2015-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MA",
"license": "MA587",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DOC FIRST",
"identifier": "042297845",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FALLON",
"identifier": "93477",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE",
"identifier": "042297845",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "AP2545",
"state": "MA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GREAT WEST HEALTH CARE",
"identifier": "042297845",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Norwell, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2015; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.