Individual provider Active NPI

Thomas Howard McNulty, PA-C

  • Physician Assistant
  • Portsmouth, NH
National Provider Identifier
1568940583
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1381 Issued in NH
Practice address
599 Lafayette Rd
Portsmouth, NH 03801-5409
Phone
(603) 942-7900
NPI assigned
Aug 1, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 1381 NH Primary

Addresses

Primary practice location

599 Lafayette Rd
Portsmouth, NH 03801-5409

Mailing address

360 US Highway 1 Byp Unit 102
Portsmouth, NH 03801-7105
Phone (603) 410-6700

Other practice location 1

125 Indian Rock Rd
Windham, NH 03087-2008
Phone (603) 890-6330

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20180910000650 NH Practitioner - Physician Assistant 0143570309 Reassigns benefits to 1 organization

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
Convenientmd - FFS UC LLCGroup PAC ID 5193186492, 397 clinicians

Practice addresses (Care Compare)

1 Portsmouth Ave
Stratham, NH 03885-2585
Phone (603) 772-3600

1 Sharma Way
Windham, NH 03087-2008
Phone (603) 890-6330

3 Nashua Rd
Bedford, NH 03110-5515
Phone (603) 472-6700

599 Lafayette Rd
Portsmouth, NH 03801-5409
Phone (603) 942-7900

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1381NHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Convenientmd - FFS UC LLC CurrentSince Aug 1, 2023 Accepting new patients
Convenientmd - FFS UC LLC CurrentSince Aug 1, 2023 Accepting new patients
Convenientmd - FFS UC LLC Past Accepting new patients

Locations

3 Nashua Rd
Bedford, NH 03110
Phone (603) 472-6700

111 New Hampshire Ave
Portsmouth, NH 03801

599 Lafayette Rd
Portsmouth, NH 03801
Phone (603) 942-7900

360 US Highway 1 Byp
Unit 102
Portsmouth, NH 03801
Phone (603) 410-6700

125 Indian Rock Rd
Windham, NH 03087
Phone (603) 890-6330

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.

NPI Registry JSON

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

{
    "created_epoch": "1533081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1568940583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 US HIGHWAY 1 BYP UNIT 102",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017105",
            "telephone_number": "603-410-6700",
            "fax_number": "603-319-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "599 LAFAYETTE RD",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038015409",
            "telephone_number": "603-942-7900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Indian Rock Rd",
            "address_purpose": "LOCATION",
            "city": "Windham",
            "state": "NH",
            "postal_code": "030872008",
            "country_code": "US",
            "telephone_number": "603-890-6330",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCNULTY",
        "first_name": "THOMAS",
        "middle_name": "HOWARD",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-01",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "1381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portsmouth, NH

Sources for this page

Verify at the official NPI Registry.