NPIMap

Individual provider Active NPI

Amy Meggan Pinkham, PA-C

  • Physician Assistant
  • Hudson, MA
National Provider Identifier
1639385131
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
AP1964 Issued in MA
Practice address
4 Main St.
Apt. 2
Hudson, MA 01749-2109
Phone
(978) 835-6212
NPI assigned
May 14, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 AP1964 MA Primary

Addresses

Primary practice location

4 Main St.
Apt. 2
Hudson, MA 01749-2109

Mailing address

34 Quail Run
Southbridge, MA 01550-3191
Phone (978) 835-6212

Other identifiers 1

IdentifierTypeStateIssuer
10074698OtherMAEMPLOYEE ID #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241112001066 RI Practitioner - Physician Assistant 4587684790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
State of Rhode IslandGroup PAC ID 8123929742, 11 clinicians

Practice addresses (Care Compare)

111 Howard Ave
Cranston, RI 02920-3001
Phone (401) 462-3666

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AP1964MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Eleanor Slater Hospital CurrentSince Oct 2, 2024 Accepting new patients
University of Massachusetts Past Accepting new patients

Locations

111 Howard Ave
Cranston, RI 02920
Phone (401) 462-3085

Organizations & group practices 2

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 6

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": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639385131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 QUAIL RUN",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "015503191",
            "telephone_number": "978-835-6212"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 MAIN ST.",
            "address_2": "APT. 2",
            "city": "HUDSON",
            "state": "MA",
            "postal_code": "017492109",
            "telephone_number": "978-835-6212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINKHAM",
        "first_name": "AMY",
        "middle_name": "MEGGAN",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "AP1964",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYEE ID #",
            "identifier": "10074698",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hudson, MA

Sources for this page

Verify at the official NPI Registry.