Kenneth Thomas Mason Jr., PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

MA062072 Issued in PA

Practice address

200 W Montgomery Ave
Ardmore, PA 19003-1416

Phone

(610) 228-0816

NPI assigned

Jan 7, 2021

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Louis P. Buckymdpc

  • Plastic Surgery Physician
  • Ardmore, PA
  • NPI 1831353473
  NPD

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

{
    "created_epoch": "1609977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609977600000",
    "number": "1528656337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W MONTGOMERY AVE",
            "city": "ARDMORE",
            "state": "PA",
            "postal_code": "190031416",
            "telephone_number": "610-228-0816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W MONTGOMERY AVE",
            "city": "ARDMORE",
            "state": "PA",
            "postal_code": "190031416",
            "telephone_number": "610-228-0816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASON",
        "first_name": "KENNETH",
        "middle_name": "THOMAS",
        "name_suffix": "Jr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-01-07",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA062072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mari Counseling Services, LLC
• Lindsey Field Marshall, D.M.D.
• Kayla Martin, PT, DPT
• Stephen Martin, PSY.D.
• Mary Ann Catherine Marzen, LCSW
• Shannon Marie Mastin, M.S.P.T
• Megan Matusky, LCSW
• William Edward Mayer, LMFT
• Tracy Lynn McAlee, MS, LPC
• Brian James McAnany, RDN

• Physician Assistant in Ardmore, PA
• Providers in Ardmore, PA by specialty
• Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.