Individual provider Active NPI

Kaleigh Ann Mca'Nulty, PA-C

  • Medical Physician Assistant
  • Nashua, NH
National Provider Identifier
1700229580
Registry record updated Nov 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
1078 Issued in NH
Practice address
22 Prospect St
Nashua, NH 03060-3924
Phone
(603) 883-1626
Fax
(603) 881-9914
NPI assigned
Apr 11, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 16, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA4623 MA
Medical Physician Assistant 363AM0700X 1078 NH Primary

Addresses

Primary practice location

22 Prospect St
Nashua, NH 03060-3924

Mailing address

675 Paramount Dr
Raynham, MA 02767-5416
Phone (508) 880-0012

Other practice location 1

675 Paramount Dr
Raynham, MA 02767-5416
Phone (508) 880-0012

Other practice location 2

738 Hooksett Rd
Manchester, NH 03104-2617
Phone (603) 384-3900

Other identifiers 1

IdentifierTypeStateIssuer
3100761MedicaidNH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
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
I20150519000771 NH Practitioner - Physician Assistant 5395976781 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lamprey Health Care IncGroup PAC ID 3577535319, 52 clinicians

Practice addresses (Care Compare)

22 Prospect St
Nashua, NH 03060-3924
Phone (603) 883-1626

7 Prospect St
Nashua, NH 03060-3921
Phone (603) 883-1626

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Convenientmd - FFS UC LLC CurrentSince Aug 1, 2023 Accepting new patients
Convenientmd - FFS UC LLC CurrentSince Aug 1, 2023 Accepting new patients
Lamprey Health Care Inc CurrentSince Mar 16, 2015 Accepting new patients
Lamprey Health Care Inc CurrentSince Mar 16, 2015 Accepting new patients
Convenientmd - FFS UC LLC Past Accepting new patients

Locations

3 Nashua Rd
Bedford, NH 03110
Phone (603) 472-6700

738 Hooksett Rd
Manchester, NH 03104
Phone (603) 384-3900

22 Prospect St
Nashua, NH 03060
Phone (603) 883-1626

7 Prospect St
Nashua, NH 03060
Phone (603) 816-7146

207 S Main St
Newmarket, NH 03857
Phone (603) 659-3106

111 New Hampshire Ave
Portsmouth, NH 03801

360 US Highway 1 Byp
Unit 102
Portsmouth, NH 03801
Phone (603) 410-6700

128 State Route 27
Raymond, NH 03077

125 Indian Rock Rd
Windham, NH 03087
Phone (603) 890-6330

Interoperability endpoints

  • Direct secure messaging: kaleigh.mca.nulty.1@28541.direct.athenahealth.com

Organizations & group practices 7

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": "1365638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700092800000",
    "number": "1700229580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "675 PARAMOUNT DR",
            "city": "RAYNHAM",
            "state": "MA",
            "postal_code": "027675416",
            "telephone_number": "508-880-0012",
            "fax_number": "508-880-0032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 PROSPECT ST",
            "city": "NASHUA",
            "state": "NH",
            "postal_code": "030603924",
            "telephone_number": "603-883-1626",
            "fax_number": "603-881-9914"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "675 Paramount Dr",
            "address_purpose": "LOCATION",
            "city": "Raynham",
            "state": "MA",
            "postal_code": "027675416",
            "country_code": "US",
            "telephone_number": "508-880-0012",
            "fax_number": "508-880-0032",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "738 Hooksett Rd",
            "address_purpose": "LOCATION",
            "city": "Manchester",
            "state": "NH",
            "postal_code": "031042617",
            "country_code": "US",
            "telephone_number": "603-384-3900",
            "fax_number": "603-384-3912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCA'NULTY",
        "first_name": "KALEIGH",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-11",
        "last_updated": "2023-11-16",
        "certification_date": "2023-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA4623",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NH",
            "license": "1078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3100761",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Nashua, NH

Sources for this page

Verify at the official NPI Registry.