Individual provider Active NPI

Ryan Leigh Macdonald, PA

  • Surgical Physician Assistant
  • Springfield, MA
National Provider Identifier
1518324904
Registry record updated Jan 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA5484 Issued in MA
Practice address
3640 Main St
Suite 302
Springfield, MA 01107-1145
Phone
(413) 732-4242
NPI assigned
Jan 15, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA5484 MA Primary

Addresses

Primary practice location

3640 Main St
Suite 302
Springfield, MA 01107-1145

Mailing address

3640 Main St
Suite 302
Springfield, MA 01107-1145
Phone (413) 732-4242

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
I20160302001013 MA Practitioner - Physician Assistant 6305142290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

3640 Main St
Suite 302
Springfield, MA 01107-1134
Phone (855) 830-8346

463 Worcester Rd
Suite 205
Framingham, MA 01701-5354
Phone (855) 830-8346

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA5484MAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Vein Restoration Ma LLC CurrentSince Feb 20, 2023 Accepting new patients

Locations

463 Worcester Rd
Ste 205
Framingham, MA 01701
Phone (774) 242-4222

89 Main St
Ste 401
Milford, MA 01757

3640 Main St
Ste 302
Springfield, MA 01107
Phone (413) 732-4242

7 Alfred St
Ste 320
Woburn, MA 01801
Phone (781) 505-8760

7474 Greenway Center Dr
Ste 1000
Greenbelt, MD 20770
Phone (240) 965-3271

Interoperability endpoints

  • Direct secure messaging: ryan.macdonaldpa.p3@direct.cvr.nextgenshare.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1452816000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452816000000",
    "number": "1518324904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3640 MAIN ST",
            "address_2": "SUITE 302",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071145",
            "telephone_number": "413-732-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3640 MAIN ST",
            "address_2": "SUITE 302",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011071145",
            "telephone_number": "413-732-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACDONALD",
        "first_name": "RYAN",
        "middle_name": "LEIGH",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-15",
        "last_updated": "2016-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "PA5484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.