Active NPI
Heather S Gangloff, PA
- Medical Physician Assistant
- Concord, MA
National Provider Identifier
1649234899
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 1273
- Practice address
- 330 Baker Ave
Concord, MA 01742-2129 - Phone
- (978) 287-9300
- NPI assigned
- Apr 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 1273 | MA | |
| Medical Physician Assistant | 363AM0700X | 1273 | MA | Primary |
Addresses
Primary practice location
330 Baker Ave
Concord, MA 01742-2129
Mailing address
330 Baker Ave
Concord, MA 01742-2129
Phone (978) 287-9300
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | hgangloff12289@direct.atrius.masshiway.net |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081126000023 | MA | Practitioner - Physician Assistant | 8729148408 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1273 | MA | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Atrius Health, Inc. | Physician Assistant | Current | Accepting new patients |
| Atrius Health, Inc. | Physician Assistant | Past | Accepting new patients |
Locations
147 Milk St
Fl 9
Boston, MA 02109
Phone (617) 559-8051
133 Brookline Ave
Boston, MA 02215
Phone (617) 421-1000
147 Milk St
#9
Boston, MA 02109
Phone (617) 859-5170
330 Baker Ave
Concord, MA 01742
Phone (978) 287-9300
Interoperability endpoints
- hgangloff12289@direct.atrius.masshiway.net
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1605484800000",
"number": "1649234899",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "330 BAKER AVE",
"city": "CONCORD",
"state": "MA",
"postal_code": "017422129",
"telephone_number": "978-287-9300"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "330 BAKER AVE",
"city": "CONCORD",
"state": "MA",
"postal_code": "017422129",
"telephone_number": "978-287-9300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GANGLOFF",
"first_name": "HEATHER",
"middle_name": "S",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-04-14",
"last_updated": "2020-11-16",
"certification_date": "2020-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "MA",
"license": "1273",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "MA",
"license": "1273",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "hgangloff12289@direct.atrius.masshiway.net",
"affiliation": "N",
"address_1": "330 Baker Ave",
"city": "Concord",
"state": "MA",
"country_code": "US",
"postal_code": "017422129",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Concord, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.