Active NPI
Kyle D Macdonald, PHARMD
- Pharmacist
- Worcester, MA
National Provider Identifier
1558770453
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH235329
- Practice address
- 55 Lake Ave N Ste Ac1.033
Worcester, MA 01655-0002 - Phone
- (888) 639-3988
- NPI assigned
- Aug 5, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH235329 | MA | Primary |
Addresses
Primary practice location
55 Lake Ave N Ste Ac1.033
Worcester, MA 01655-0002
Mailing address
55 Lake Ave N Ste Ac1.033
Worcester, MA 01655-0002
Phone (888) 639-3988
Other practice location 1
937 W Boylston St
Worcester, MA 01606-1139
Phone (508) 856-7901
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH235329 | MA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Umass Memorial Medical Center, Inc. | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Organizations & group practices 3
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.
-
dba UMass Memorial Medical Center Specialty Pharmacy
- Community/Retail Pharmacy
- Worcester, MA
- NPI 1831461086
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600819200000",
"number": "1558770453",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "55 LAKE AVE N STE AC1.033",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016550002",
"telephone_number": "888-639-3988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "55 LAKE AVE N STE AC1.033",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016550002",
"telephone_number": "888-639-3988"
}
],
"practiceLocations": [
{
"address_1": "937 W Boylston St",
"address_purpose": "LOCATION",
"city": "Worcester",
"state": "MA",
"postal_code": "016061139",
"country_code": "US",
"telephone_number": "508-856-7901",
"fax_number": "508-856-7907",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MACDONALD",
"first_name": "KYLE",
"middle_name": "D",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-08-05",
"last_updated": "2020-09-23",
"certification_date": "2020-09-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MA",
"license": "PH235329",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.