Individual provider Active NPI

Kyle B Sargent, FNP-BC

  • Physician Assistant
  • Quincy, MA
National Provider Identifier
1518690304
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9238 Issued in MA
Practice address
479 Washington St
Quincy, MA 02169-5895
Phone
(857) 529-5220
Fax
(857) 529-5422
NPI assigned
Jul 8, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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
Physician Assistant 363A00000X PA9238 MA Primary

Addresses

Primary practice location

479 Washington St
Quincy, MA 02169-5895

Mailing address

360 US Highway 1 Byp Unit 102
Portsmouth, NH 03801-7105
Phone (603) 410-6700

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
I20230302002570 MA Practitioner - Physician Assistant 3779956230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Convenientmd - FFS UC LLCGroup PAC ID 5193186492, 397 clinicians

Practice addresses (Care Compare)

1285 Belmont St
Suite 1
Brockton, MA 02301-4440
Phone (508) 894-7015

140 Samoset St
Suite 2
Plymouth, MA 02360-4802
Phone (508) 209-5362

180 Main St
Saugus, MA 01906-4502
Phone (339) 674-0978

210 Andover St
Peabody, MA 01960-1647
Phone (978) 488-3234

236 Cochituate Rd
Framingham, MA 01701-4627
Phone (774) 244-3227

245 Hartford Ave
Bellingham, MA 02019-3007
Phone (774) 295-4355

40 Davis Straits
Falmouth, MA 02540-3906
Phone (774) 255-3010

471 Ctr St
Ludlow, MA 01056-2733
Phone (413) 625-3500

86 Taunton St
Plainville, MA 02762-2131
Phone (508) 928-5211

999 Dalton Ave
Pittsfield, MA 01201-2903
Phone (413) 242-6577

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PA9238MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Convenientmd - FFS UC LLC CurrentSince Oct 7, 2023 Accepting new patients
Convenientmd - FFS UC LLC CurrentSince Oct 7, 2023 Accepting new patients
Convenientmd - FFS UC LLC Past Accepting new patients
Convenientmd LLC Past Accepting new patients

Locations

245 Hartford Ave
Bellingham, MA 02019
Phone (774) 295-4355

40 Davis Straits
Falmouth, MA 02540
Phone (774) 255-3010

479 Washington St
Quincy, MA 02169
Phone (617) 404-8398

360 US Highway 1 Byp
Unit 102
Portsmouth, NH 03801
Phone (603) 410-6700

Organizations & group practices 5

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": "1657238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1518690304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 US HIGHWAY 1 BYP UNIT 102",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017105",
            "telephone_number": "603-410-6700",
            "fax_number": "603-319-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "479 WASHINGTON ST",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021695895",
            "telephone_number": "857-529-5220",
            "fax_number": "857-529-5422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARGENT",
        "first_name": "KYLE",
        "middle_name": "B",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-07-08",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA9238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

Verify at the official NPI Registry.