Individual provider Active NPI

Michaela Jean Pimentel, PA-C

  • Surgical Physician Assistant
  • Plymouth, MA
National Provider Identifier
1528544772
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA6621 Issued in MA
Practice address
275 Sandwich St
Plymouth, MA 02360-2183
Phone
(508) 746-2000
NPI assigned
Jul 11, 2018
Last updated
Mar 1, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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 PA6621 MA Primary

Addresses

Primary practice location

275 Sandwich St
Plymouth, MA 02360-2183

Mailing address

68 Cottage Dr
West Yarmouth, MA 02673-3518
Phone (508) 340-2671

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
I20180809004006 MA Practitioner - Physician Assistant 5890043798 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Physicians of Cape Cod HospitalGroup PAC ID 9638326671, 330 clinicians

Practice addresses (Care Compare)

27 Park St
Hyannis, MA 02601-5230
Phone (774) 552-6000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA6621MAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jordan Physician Associates, Inc. CurrentSince Aug 1, 2018 Accepting new patients

Locations

275 Sandwich St
Plymouth, MA 02360
Phone (508) 746-2000

46 Obery St
Plymouth, MA 02360
Phone (508) 210-5920

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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": "1531267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1528544772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 COTTAGE DR",
            "city": "WEST YARMOUTH",
            "state": "MA",
            "postal_code": "026733518",
            "telephone_number": "508-340-2671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 SANDWICH ST",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023602183",
            "telephone_number": "508-746-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIMENTEL",
        "first_name": "MICHAELA",
        "middle_name": "JEAN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-11",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "PA6621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.