Individual provider Active NPI

Michael D Ierardi, PA-C

  • Surgical Physician Assistant
  • Peabody, MA
National Provider Identifier
1538147012
Registry record updated Jul 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
437 Issued in MA
Practice address
1 Orthopedic Dr
2ND Floor
Peabody, MA 01960-1668
Phone
(978) 818-6350
Fax
(978) 818-6355
NPI assigned
Jan 5, 2006
Last updated
Jul 1, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2010

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 437 MA Primary

Addresses

Primary practice location

1 Orthopedic Dr
2ND Floor
Peabody, MA 01960-1668

Mailing address

1 Orthopedic Dr
2ND Floor
Peabody, MA 01960-1668
Phone (978) 818-6350

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
I20041014000063 MA Practitioner - Physician Assistant 3375503360 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1 Orthopedics Dr
Peabody, MA 01960-1668
Phone (978) 818-6350

331 Gloucester Crossing Rd
Gloucester, MA 01930-2283
Phone (978) 879-4047

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
437MAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Sports Medicine North Orthopaedic Surgery, Inc CurrentSince Jun 1, 2004 Accepting new patients

Locations

1 Orthopedics Dr
Peabody, MA 01960
Phone (781) 595-4562

1 Orthopedics Dr
Ste 2
Peabody, MA 01960
Phone (978) 818-6493

Interoperability endpoints

  • Direct secure messaging: michael.ierardi.1@7605.direct.athenahealth.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

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": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277942400000",
    "number": "1538147012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 ORTHOPEDIC DR",
            "address_2": "2ND FLOOR",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019601668",
            "telephone_number": "978-818-6350",
            "fax_number": "978-818-6355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 ORTHOPEDIC DR",
            "address_2": "2ND FLOOR",
            "city": "PEABODY",
            "state": "MA",
            "postal_code": "019601668",
            "telephone_number": "978-818-6350",
            "fax_number": "978-818-6355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IERARDI",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-05",
        "last_updated": "2010-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "437",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peabody, MA

Sources for this page

Verify at the official NPI Registry.