Individual provider Active NPI

Elizabeth McDonald, PA-C

  • Physician Assistant
  • Woburn, MA
National Provider Identifier
1780026641
Registry record updated Nov 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA4768 Issued in MA
Practice address
100 Tradecenter
Suite 750
Woburn, MA 01801-1851
Phone
(781) 937-3001
Fax
(781) 937-3070
NPI assigned
Jul 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2016

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 PA4768 MA Primary

Addresses

Primary practice location

100 Tradecenter
Suite 750
Woburn, MA 01801-1851

Mailing address

100 Sylvan Rd Ste 750
Woburn, MA 01801-1852
Phone (781) 937-3001

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
I20150218001381 MA Practitioner - Physician Assistant 0244555050 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ear, Nose and Throat Consultants, IncGroup PAC ID 0042256463, 8 clinicians

Practice addresses (Care Compare)

1021 Main St
Suite 105
Winchester, MA 01890-1971
Phone (781) 729-8845

Hospital & facility affiliations

  • Winchester Hospital Hospital, Winchester, MA, CCN 220105

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA4768MAMDPhysician Assistant

Organizations & group practices 1

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": "1374278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479686400000",
    "number": "1780026641",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SYLVAN RD STE 750",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011852",
            "telephone_number": "781-937-3001",
            "fax_number": "781-937-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 TRADECENTER",
            "address_2": "SUITE 750",
            "city": "WOBURN",
            "state": "MA",
            "postal_code": "018011851",
            "telephone_number": "781-937-3001",
            "fax_number": "781-937-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDONALD",
        "first_name": "ELIZABETH",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-20",
        "last_updated": "2016-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA4768",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woburn, MA

Sources for this page

Verify at the official NPI Registry.