Individual provider Active NPI

Michael Patrick O'Rourke, PA-C

  • Physician Assistant
  • Cambridge, MA
National Provider Identifier
1629528435
Registry record updated Oct 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA5914 Issued in MA
Practice address
330 Mount Auburn St
Department of Emergency Medicine
Cambridge, MA 02138-5502
Phone
(617) 499-5025
NPI assigned
Oct 5, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 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 PA5914 MA Primary

Addresses

Primary practice location

330 Mount Auburn St
Department of Emergency Medicine
Cambridge, MA 02138-5502

Mailing address

330 Mount Auburn St
Department of Emergency Medicine
Cambridge, MA 02138-5502

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, WA2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20161206001745 MA Practitioner - Physician Assistant 9537449780 Reassigns benefits to 1 organization
I20210512001610 WA Practitioner - Physician Assistant 9537449780 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Seattle Childrens HospitalGroup PAC ID 9032021050, 113 clinicians

Practice addresses (Care Compare)

1035 116TH Ave NE
Bellevue, WA 98004-4604
Phone (425) 688-5000

4800 Sand Point Way NE
Seattle, WA 98105-3901
Phone (206) 987-2000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA5914MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Association of CHMC and University Physicians CurrentSince Feb 2, 2022 Accepting new patients
Mt Auburn Professional Services CurrentSince Nov 22, 2016 Accepting new patients
Seattle Childrens Hospital CurrentSince Feb 23, 2022 Accepting new patients
Seattle Children'S Hospital CurrentSince Feb 23, 2022 Accepting new patients
The Association of Chrmc and University Physicians CurrentSince Feb 2, 2022 Accepting new patients
Seattle Children'S Hospital Past Accepting new patients

Locations

330 Mount Auburn St
Cambridge, MA 02138
Phone (617) 499-5054

57 Bedford St
Ste 130
Lexington, MA 02420
Phone (781) 484-7500

1035 116th Ave NE
Bellevue, WA 98004
Phone (425) 451-4141

16251 Sylvester Rd SW
Burien, WA 98166
Phone (206) 244-9970

900 Pacific Ave
Ste 100
Everett, WA 98201
Phone (425) 304-6080

8232 W Grandridge Blvd
Kennewick, WA 99336
Phone (509) 582-1700

4800 Sand Point Way NE
Seattle, WA 98105
Phone (206) 526-2000

1780 NW Myhre Rd
Ste 2120
Silverdale, WA 98383
Phone (360) 782-3100

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/86/brand/1/csg/1/fhir/r4
  • Direct secure messaging: morourke175699@direct.seattlechildrens.org

Organizations & group practices 9

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": "1475625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475625600000",
    "number": "1629528435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 MOUNT AUBURN ST",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 MOUNT AUBURN ST",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
            "city": "CAMBRIDGE",
            "state": "MA",
            "postal_code": "021385502",
            "telephone_number": "617-499-5025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'ROURKE",
        "first_name": "MICHAEL",
        "middle_name": "PATRICK",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-10-05",
        "last_updated": "2016-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA5914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cambridge, MA

Sources for this page

Verify at the official NPI Registry.