Individual provider Active NPI

Gavin Jepson, PA-C

  • Physician Assistant
  • Plymouth, MA
National Provider Identifier
1699447151
Registry record updated Oct 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA8288 Issued in MA
Practice address
30 Aldrin Rd
Plymouth, MA 02360-4804
Phone
(508) 746-8977
NPI assigned
Oct 4, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2021

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 PA8288 MA Primary

Addresses

Primary practice location

30 Aldrin Rd
Plymouth, MA 02360-4804

Mailing address

30 Aldrin Rd
Plymouth, MA 02360-4804
Phone (508) 746-8977

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
I20211118001697 MA Practitioner - Physician Assistant 8224427919 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Bernard J Durante MD PCGroup PAC ID 3577539410, 16 clinicians

Practice addresses (Care Compare)

1 County Rd
Bourne, MA 02532-3756
Phone (508) 746-8977

30 Aldrin Rd
Plymouth, MA 02360-4804
Phone (508) 746-8977

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bernard J Durante MD PC CurrentSince Aug 14, 2021 Accepting new patients
Bernard J Durante MD PC CurrentSince Aug 14, 2021 Accepting new patients

Locations

30 Aldrin Rd
Plymouth, MA 02360
Phone (508) 746-8977

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1633305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1699447151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 ALDRIN RD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023604804",
            "telephone_number": "508-746-8977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 ALDRIN RD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023604804",
            "telephone_number": "508-746-8977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JEPSON",
        "first_name": "GAVIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-04",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA8288",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Plymouth, MA

Sources for this page

Verify at the official NPI Registry.