Individual provider Active NPI

Renee Cavanaugh, PA

  • Physician Assistant
  • Nashua, NH
National Provider Identifier
1578770897
Registry record updated Sep 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
0552 Issued in NH
Practice address
2300 Southwood Dr
Family Medicine
Nashua, NH 03063-1818
Phone
(603) 577-4440
NPI assigned
May 17, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2016

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 0552 NH Primary

Addresses

Primary practice location

2300 Southwood Dr
Family Medicine
Nashua, NH 03063-1818

Mailing address

2300 Southwood Dr
Family Medicine
Nashua, NH 03063-1818
Phone (603) 577-4440

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
I20051004000770 NH Practitioner - Physician Assistant 7618902040 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mary Hitchcock Memorial HospitalGroup PAC ID 4486561164, 1,269 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Lebanon, NH 03756-1000
Phone (603) 650-5000

2300 Southwood Dr
Nashua, NH 03063-1818
Phone (603) 577-4000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
79.66 of 100Reported as apm
Quality
53.51
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
0552NHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mary Hitchcock Memorial Hospital CurrentSince Jun 1, 2023 Accepting new patients
Mary Hitchcock Memorial Hospital CurrentSince Jun 1, 2023 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Sep 12, 2016 Accepting new patients
Dartmouth-Hitchcock Clinic CurrentSince Sep 12, 2016 Accepting new patients
Mary Hitchcock Memorial Hospital Past Accepting new patients

Locations

14 Tsienneto Rd
Bldg B
Derry, NH 03038

1 Medical Dr
Lebanon, NH 03756
Phone (603) 650-5922

2300 Southwood Dr
Nashua, NH 03063
Phone (603) 577-4170

8 Prospect St
Nashua, NH 03060
Phone (603) 281-9275

Interoperability endpoints

  • Direct secure messaging: rcavanaugh241037@direct.dartmouth-hitchcock.org

Organizations & group practices 5

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 4

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": "1179360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474502400000",
    "number": "1578770897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2300 SOUTHWOOD DR",
            "address_2": "FAMILY MEDICINE",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030631818",
            "telephone_number": "603-577-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 SOUTHWOOD DR",
            "address_2": "FAMILY MEDICINE",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030631818",
            "telephone_number": "603-577-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CAVANAUGH",
        "first_name": "RENEE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-17",
        "last_updated": "2016-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "0552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashua, NH

Sources for this page

Verify at the official NPI Registry.