Individual provider Active NPI

Michael M Macgregor, P.A.

  • Medical Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1609808203
Registry record updated Mar 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
MA051136 Issued in PA
Practice address
3401 N. Broad St.
Philadelphia, PA 19140
Phone
(215) 707-2111
Fax
(215) 707-2324
NPI assigned
Jul 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X MA051136 PA Primary

Addresses

Primary practice location

3401 N. Broad St.
Philadelphia, PA 19140

Mailing address

2450 W Hunting Park Ave
Philadelphia, PA 19129-1302
Phone (215) 707-2111

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)
Enrolled
Credentials
Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490054400000",
    "number": "1609808203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 W HUNTING PARK AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191291302",
            "telephone_number": "215-707-2111",
            "fax_number": "215-707-2324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 N. BROAD ST.",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19140",
            "telephone_number": "215-707-2111",
            "fax_number": "215-707-2324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACGREGOR",
        "first_name": "MICHAEL",
        "middle_name": "M",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2017-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA051136",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.