NPIMap

Individual provider Active NPI

Maddie Lynch, STUDENT

  • Surgical Physician Assistant
  • Lawrence, MA
National Provider Identifier
1790248912
Registry record updated Apr 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
PA7433 Issued in MA
Practice address
354 Merrimack St Ste 1
Lawrence, MA 01843-1755
Phone
(978) 687-2321
Fax
(978) 722-7287
NPI assigned
Apr 14, 2019
Last updated
Apr 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X PA7433 MA Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

354 Merrimack St Ste 1
Lawrence, MA 01843-1755

Mailing address

35 Mammoth Rd Unit C
Pelham, NH 03076-3225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA, NH2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200420002474 MA Practitioner - Physician Assistant 5193155844 Reassigns benefits to 1 organization
I20210517001171 NH Practitioner - Physician Assistant 5193155844 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
LGH Medical Group, Inc.Group PAC ID 3173626751, 165 clinicians

Practice addresses (Care Compare)

1 Hospital Dr
Lowell, MA 01852-1311
Phone (978) 942-8260

168 Kinsley St
Nashua, NH 03060-3634
Phone (978) 687-2321

25 Fletcher St
Suite 1
Chelmsford, MA 01824-2746
Phone (978) 687-2321

295 Varnum Ave
Lowell, MA 01854-2134
Phone (978) 788-7344

354 Merrimack St
Lawrence, MA 01843-1754
Phone (978) 687-2321

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA7433MAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
LGH Professional Services LLC Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: mlynch47121@tuftsmedicine.direct-ci.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1555200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585699200000",
    "number": "1790248912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 MAMMOTH RD UNIT C",
            "city": "PELHAM",
            "state": "NH",
            "postal_code": "030763225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 MERRIMACK ST STE 1",
            "city": "LAWRENCE",
            "state": "MA",
            "postal_code": "018431755",
            "telephone_number": "978-687-2321",
            "fax_number": "978-722-7287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYNCH",
        "first_name": "MADDIE",
        "credential": "STUDENT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-14",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MA",
            "license": "PA7433",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrence, MA

Sources for this page

Verify at the official NPI Registry.