Individual provider Active NPI

Elizabeth Ew Temple, PA-C

  • Physician Assistant
  • Gardner, MA
National Provider Identifier
1669470837
Registry record updated Jan 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1251 Issued in MA
Practice address
242 Green St
Gardner, MA 01440-1336
Phone
(978) 632-3420
NPI assigned
Jul 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2010

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 1251 MA Primary

Addresses

Primary practice location

242 Green St
Gardner, MA 01440-1336

Mailing address

242 Green St
Gardner, MA 01440-1336
Phone (978) 632-3420

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060417000100 MA Practitioner - Physician Assistant 6709895949 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Heywood Medical Group Inc.Group PAC ID 6901882836, 111 clinicians

Practice addresses (Care Compare)

2033 Main St
Athol, MA 01331-3535
Phone (978) 249-3511

250 Green St
Gardner, MA 01440-1396
Phone (978) 630-6460

81 Reservoir Dr
Athol, MA 01331-4901
Phone (978) 248-5135

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
82.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1251MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Henry Heywood Memorial Hospital CurrentSince Nov 17, 2009 Accepting new patients
Heywood Medical Group Inc CurrentSince Jan 1, 2017 Accepting new patients
Athol Memorial Hospital Incorporated Physician Assistant CurrentSince Jun 1, 2017 Accepting new patients

Locations

81 Reservoir Dr
Side
Athol, MA 01331

2033 Main St
Athol, MA 01331
Phone (978) 249-1295

242 Green St
Gardner, MA 01440
Phone (978) 258-4734

250 Green St
Gardner, MA 01440
Phone (978) 630-5050

266 Main St
Gardner, MA 01440
Phone (978) 630-5030

Interoperability endpoints

  • Direct secure messaging: elizabeth.temple.1@192.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/192/brand/1/csg/123/fhir/r4

Organizations & group practices 5

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 3

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": "1121126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264118400000",
    "number": "1669470837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 GREEN ST",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014401336",
            "telephone_number": "978-632-3420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 GREEN ST",
            "city": "GARDNER",
            "state": "MA",
            "postal_code": "014401336",
            "telephone_number": "978-632-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEMPLE",
        "first_name": "ELIZABETH",
        "middle_name": "EW",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-12",
        "last_updated": "2010-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "1251",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gardner, MA

Sources for this page

Verify at the official NPI Registry.