Individual provider Active NPI

George William Horsley, PA-C

  • Physician Assistant
  • Southbridge, MA
National Provider Identifier
1780678631
Registry record updated Apr 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA1124 Issued in MA
Practice address
100 South St
Southbridge, MA 01550-4051
Phone
(508) 765-9771
NPI assigned
Sep 7, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2017

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 PA1124 MA Primary

Addresses

Primary practice location

100 South St
Southbridge, MA 01550-4051

Mailing address

PO Box 40
Southbridge, MA 01550-0040
Phone (508) 909-7799

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
I20170419001023 MA Practitioner - Physician Assistant 6709825359 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
001002CTMDSpeech-Language Pathologist
PA1124MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Harvard Medical Faculty Phys at Beth Israel Deaconess Med Ctr Inc CurrentSince Oct 1, 2019 Accepting new patients
Oakfield Drive Emergency Physicians LLC Physician Assistant Past Accepting new patients
Nes Rhode Island, Inc. Past Accepting new patients
Pride Emergency Physicians LLC Past Accepting new patients

Locations

330 Brookline Ave
Boston, MA 02215
Phone (617) 667-2000

199 Reedsdale Rd
Milton, MA 02186
Phone (617) 313-1000

101 Page St
New Bedford, MA 02740
Phone (508) 961-5425

100 South St
Southbridge, MA 01550
Phone (508) 764-8012

Organizations & group practices 4

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": "1126051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491523200000",
    "number": "1780678631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "015500040",
            "telephone_number": "508-909-7799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SOUTH ST",
            "city": "SOUTHBRIDGE",
            "state": "MA",
            "postal_code": "015504051",
            "telephone_number": "508-765-9771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORSLEY",
        "first_name": "GEORGE",
        "middle_name": "WILLIAM",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-07",
        "last_updated": "2017-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA1124",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southbridge, MA

Sources for this page

Verify at the official NPI Registry.