NPIMap

Individual provider Active NPI

Amy Bonner Esdale, MD

  • Family Medicine Physician
  • Gloucester, MA
National Provider Identifier
1538256532
Registry record updated Jan 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
78116 Issued in MA
Practice address
298 Washington St
Gloucester, MA 01930-4832
Phone
(978) 283-2726
Fax
(978) 283-0840
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 78116 MA Primary

Addresses

Primary practice location

298 Washington St
Gloucester, MA 01930-4832

Mailing address

298 Washington St
Gloucester, MA 01930-4832
Phone (978) 283-2726

Other identifiers 1

IdentifierTypeStateIssuer
6191045MedicaidMA

Other names 1

  • Dr. Amy Bonner Fitzpatrick Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050325000712 MA Practitioner - Family PracticePractitioner - Internal Medicine 3375599921 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Medical College of Pennsylvania, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

15 Railroad Ave
South Hamilton, MA 01982-2218
Phone (978) 468-7381

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
91.98 of 100Reported as apm
Quality
76.59
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Beth Israel Lahey Health Primary Care, Inc. CurrentSince Oct 10, 2024 Accepting new patients
Beth Israel Lahey Health Primary Care Inc CurrentSince Oct 10, 2024 Accepting new patients
Beth Israel Lahey Health Specialty Care, Inc. CurrentSince Sep 16, 1993 Accepting new patients
Beth Israel Lahey Health Primary Care, Inc. Past Accepting new patients

Locations

41 Mall Rd
Burlington, MA 01805
Phone (781) 744-8400

298 Washington St
Fl 1
Gloucester, MA 01930
Phone (978) 283-2726

298 Washington St
Fl 4
Gloucester, MA 01930
Phone (978) 283-2726

298 Washington St
Gloucester, MA 01930
Phone (978) 283-4000

15 Railroad Ave
South Hamilton, MA 01982
Phone (978) 468-7381

Interoperability endpoints

  • FHIR API: https://fhir.laheyhealth.org/proxy-prd-fhir/api/FHIR/R4/
  • Direct secure messaging: aesdale22753@direct.bilh.masshiway.net
  • FHIR API: https://api.platform.athenahealth.com/10729/brand/1/csg/1/fhir/r4

Organizations & group practices 4

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.

Hospital & facility affiliations 6

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1327017600000",
    "number": "1538256532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "298 WASHINGTON ST",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "019304832",
            "telephone_number": "978-283-2726",
            "fax_number": "978-283-0840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "298 WASHINGTON ST",
            "city": "GLOUCESTER",
            "state": "MA",
            "postal_code": "019304832",
            "telephone_number": "978-283-2726",
            "fax_number": "978-283-0840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESDALE",
        "first_name": "AMY",
        "middle_name": "BONNER",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2012-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "78116",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6191045",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMY",
            "last_name": "FITZPATRICK",
            "middle_name": "BONNER",
            "prefix": "DR.",
            "credential": "MD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Gloucester, MA

Sources for this page

Verify at the official NPI Registry.