Individual provider Active NPI

Michael V Stewart, PA-C

  • Medical Physician Assistant
  • Springfield, MA
National Provider Identifier
1679845713
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA4339 Issued in MA
Practice address
819 Worcester St Ste 1
Springfield, MA 01151-1056
Phone
(413) 304-2501
Fax
(413) 789-0290
NPI assigned
Feb 6, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 4977 WI
Physician Assistant 363A00000X PA2390 TN
Medical Physician Assistant 363AM0700X PA4339 MA Primary
Physician Assistant 363A00000X 0010-03656 NC
Physician Assistant 363A00000X PA00633 RI
Physician Assistant 363A00000X 0877 NH

Addresses

Primary practice location

819 Worcester St Ste 1
Springfield, MA 01151-1056

Mailing address

819 Worcester St Ste 1
Springfield, MA 01151-1056
Phone (413) 304-2501

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, AZ2 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
I20210610002626 MA Practitioner - Physician Assistant 4082875877 Reassigns benefits to 6 organizations
I20241117000059 AZ Practitioner - Physician Assistant 4082875877 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
10639AZMDPhysical Therapist
0877NHMDOccupational Therapist
PA2390TNMDPhysician Assistant
4977WIMDPhysician Assistant
PA4339MAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Devens Treatment & Recovery Center, LLC CurrentSince Oct 27, 2025 Accepting new patients
Memorial Hospital Past Accepting new patients
Ipc Hospitalists of New England, P.C. Physician Assistant Past Accepting new patients

Locations

19 Midstate Dr
Ste 110
Auburn, MA 01501

85 Patton Rd
Devens, MA 01434
Phone (978) 615-5200

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": "1328486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1671062400000",
    "number": "1679845713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "819 WORCESTER ST STE 1",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011511056",
            "telephone_number": "413-304-2501",
            "fax_number": "413-789-0290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 WORCESTER ST STE 1",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011511056",
            "telephone_number": "413-304-2501",
            "fax_number": "413-789-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "MICHAEL",
        "middle_name": "V",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-06",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WI",
            "license": "4977",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "PA2390",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA4339",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-03656",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA00633",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NH",
            "license": "0877",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

Verify at the official NPI Registry.