Individual provider Active NPI

Michael McMahon, P.A.

  • Medical Physician Assistant
  • Wallingford, CT
National Provider Identifier
1629072442
Registry record updated Apr 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
000844 Issued in CT
Practice address
1062 Barnes Rd
Ste 300
Wallingford, CT 06492-2576
Phone
(203) 265-9831
Fax
(203) 265-2977
NPI assigned
Jun 9, 2005
Last updated
Apr 28, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2008

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 000844 CT Primary

Addresses

Primary practice location

1062 Barnes Rd
Ste 300
Wallingford, CT 06492-2576

Mailing address

1062 Barnes Rd
Ste 300
Wallingford, CT 06492-2576
Phone (203) 265-9831

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20080107000432 CT Practitioner - Physician Assistant 7517047319 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hartford Healthcare Medical Group Specialists PLLCGroup PAC ID 3173866241, 1,555 clinicians

Practice addresses (Care Compare)

1244 Storrs Rd
Road
Storrs, CT 06268-2200
Phone (860) 724-2579

1290 Silas Deane Hwy
Wethersfield, CT 06109-4337
Phone (860) 827-7695

462 Queen St
Southington, CT 06489-1801

863 N Main St Ext
Suite 101
Wallingford, CT 06492-2434
Phone (203) 269-3791

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.42 of 100Reported as group
Quality
83.36
Promoting interoperability
100
Improvement activities
40
Cost
75.9

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
000844CTMDPodiatrist

Practice roles

OrganizationSpecialtyStatusNew patients
Hartford Healthcare Medical Group Specialists, PLLC CurrentSince Jun 1, 2019 Accepting new patients
Consulting Cardiologists, P.C. CurrentSince Jan 1, 2019 Accepting new patients
Hartford Healthcare Medical Group Specialists LLC CurrentSince Jun 1, 2019 Accepting new patients
Connecticut Heart Physicians, Inc. PastSince Jul 24, 2006 Accepting new patients
Masonicare Primary Care Physicians PastSince Oct 1, 2001 Accepting new patients
Masonicare Behavioral Health, LLC PastSince Dec 17, 2007 Accepting new patients

Locations

85 Seymour St
Ste 719
Hartford, CT 06106
Phone (860) 249-9175

435 Lewis Ave
Meriden, CT 06451
Phone (203) 284-1340

1244 Storrs Rd
Storrs Mansfield, CT 06268
Phone (860) 724-2579

1062 Barnes Rd
Ste 300
Wallingford, CT 06492
Phone (203) 265-9831

1290 Silas Deane Hwy
Wethersfield, CT 06109
Phone (860) 972-6977

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/6291/brand/1/csg/1/fhir/r4

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

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": "1118275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209340800000",
    "number": "1629072442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1062 BARNES RD",
            "address_2": "STE 300",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922576",
            "telephone_number": "203-265-9831",
            "fax_number": "203-265-2977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1062 BARNES RD",
            "address_2": "STE 300",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922576",
            "telephone_number": "203-265-9831",
            "fax_number": "203-265-2977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMAHON",
        "first_name": "MICHAEL",
        "name_prefix": "Mr.",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-09",
        "last_updated": "2008-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CT",
            "license": "000844",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wallingford, CT

Sources for this page

Verify at the official NPI Registry.