Individual provider Active NPI

Ronald R Sargent, PA-C

  • Physician Assistant
  • Baldwinville, MA
National Provider Identifier
1770569493
Registry record updated Aug 23, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
880 Issued in MA
Practice address
184 Freight Shed Rd
Baldwinville, MA 01436-1525
Phone
(978) 652-4073
Fax
(978) 939-1110
NPI assigned
Dec 15, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2022

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 880 MA Primary

Addresses

Primary practice location

184 Freight Shed Rd
Baldwinville, MA 01436-1525

Mailing address

184 Freight Shed Rd
Baldwinville, MA 01436-1525
Phone (978) 652-4073

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
I20210811002508 MA Order and Referring Only - Physician Assistant 4385741891

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
880MAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Tufts University Past Accepting new patients
Department of Developmental Services Past Accepting new patients

Organizations & group practices 2

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": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661212800000",
    "number": "1770569493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 FREIGHT SHED RD",
            "city": "BALDWINVILLE",
            "state": "MA",
            "postal_code": "014361525",
            "telephone_number": "978-652-4073",
            "fax_number": "978-939-1110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 FREIGHT SHED RD",
            "city": "BALDWINVILLE",
            "state": "MA",
            "postal_code": "014361525",
            "telephone_number": "978-652-4073",
            "fax_number": "978-939-1110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SARGENT",
        "first_name": "RONALD",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-15",
        "last_updated": "2022-08-23",
        "certification_date": "2022-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "880",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baldwinville, MA

Sources for this page

Verify at the official NPI Registry.