Individual provider Active NPI

Kevin Michael Hughes

  • Student in an Organized Health Care Education/Training Program
  • Brockton, MA
National Provider Identifier
1578023586
Registry record updated Apr 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
110 Liberty St
Brockton, MA 02301-5674
Phone
(508) 565-3055
Fax
(508) 894-0757
NPI assigned
Mar 25, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Primary
Orthopaedic Surgery Physician 207X00000X 1017877 MA

Addresses

Primary practice location

110 Liberty St
Brockton, MA 02301-5674

Mailing address

110 Liberty St
Brockton, MA 02301-5674
Phone (508) 565-3055

Other practice location 1

55 Lake Ave N
Worcester, MA 01655-0002
Phone (508) 334-1000

Other practice location 2

680 Centre St
Brockton, MA 02302-3308
Phone (085) 653-0555

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250507001276 MA Practitioner - Orthopedic Surgery 7416283569 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic Surgery
Education
Albany Medical College of Union University, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Signature Healthcare Medical Group IncGroup PAC ID 7719876267, 250 clinicians

Practice addresses (Care Compare)

110 Liberty St
Brockton, MA 02301-5521
Phone (508) 894-0400

Hospital & facility affiliations

  • Signature Healthcare Brockton Hospital Hospital, Brockton, MA, CCN 220052

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1017877MAMDOrthopaedic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Signature Healthcare Medical Group Inc Orthopaedic Surgery CurrentSince Jun 30, 2025 Accepting new patients

Locations

110 Liberty St
Brockton, MA 02301

680 Centre St
Brockton, MA 02302
Phone (508) 941-7400

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Organizations & group practices 1

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 1

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": "1553472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1578023586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 LIBERTY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015674",
            "telephone_number": "508-565-3055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LIBERTY ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023015674",
            "telephone_number": "508-565-3055",
            "fax_number": "508-894-0757"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "55 Lake Ave N",
            "address_purpose": "LOCATION",
            "city": "Worcester",
            "state": "MA",
            "postal_code": "016550002",
            "country_code": "US",
            "telephone_number": "508-334-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "680 Centre St",
            "address_purpose": "LOCATION",
            "city": "Brockton",
            "state": "MA",
            "postal_code": "023023308",
            "country_code": "US",
            "telephone_number": "085-653-0555",
            "fax_number": "508-894-0757",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUGHES",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-25",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "MA",
            "license": "1017877",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brockton, MA

Sources for this page

Verify at the official NPI Registry.