Individual provider Active NPI

Maeve Riane Tobin, PA-C

  • Physician Assistant
  • Pawtucket, RI
National Provider Identifier
1689153454
Registry record updated May 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA01075 Issued in RI
Practice address
333 School St Ste 112a
Pawtucket, RI 02860-5336
Phone
(401) 728-6990
NPI assigned
Aug 12, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 24, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X PA01075 RI
Physician Assistant 363A00000X PA01075 RI Primary

Addresses

Primary practice location

333 School St Ste 112a
Pawtucket, RI 02860-5336

Mailing address

140 Courtland St Apt 1R
Providence, RI 02909-1429
Phone (978) 994-7175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 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
I20200812001296 RI Practitioner - Physician Assistant 7911323621 Reassigns benefits to 1 organization
I20230731000988 MA Practitioner - Physician Assistant 7911323621 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Northeast Dermatology Associates PCGroup PAC ID 3072403799, 84 clinicians

Practice addresses (Care Compare)

538 Turnpike St
North Andover, MA 01845-5812
Phone (978) 691-5690

62 Brown St
Suite 304C
Haverhill, MA 01830-6790
Phone (978) 228-1900

Hospital & facility affiliations

  • Anna Jaques Hospital Hospital, Newburyport, MA, CCN 220029

Merit-based Incentive Payment System (MIPS)

Final score
86.63 of 100Reported as group
Quality
84.27
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA01075RIMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Dermatology Associates, PC CurrentSince Sep 17, 2023 Accepting new patients
Neda at North Shore PC Dermatology CurrentSince Sep 17, 2023 Accepting new patients

Locations

62 Brown St
Ste 304C
Haverhill, MA 01830
Phone (603) 552-3309

1 Wallace Bashaw Way
Ste 3001
Newburyport, MA 01950
Phone (978) 255-3376

538 Turnpike St
North Andover, MA 01845
Phone (978) 683-9201

302 Innovation Dr
Ste 400
Franklin, TN 37067

Interoperability endpoints

  • Direct secure messaging: maeve.tobin@pd.eclinicaldirectplus.com

Organizations & group practices 3

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 1

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": "1534032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653350400000",
    "number": "1689153454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 COURTLAND ST APT 1R",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029091429",
            "telephone_number": "978-994-7175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 SCHOOL ST STE 112A",
            "city": "PAWTUCKET",
            "state": "RI",
            "postal_code": "028605336",
            "telephone_number": "401-728-6990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBIN",
        "first_name": "MAEVE",
        "middle_name": "RIANE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-12",
        "last_updated": "2022-05-24",
        "certification_date": "2022-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "RI",
            "license": "PA01075",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "RI",
            "license": "PA01075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pawtucket, RI

Sources for this page

Verify at the official NPI Registry.