Individual provider Active NPI

Michelle L Dybala, PA

  • Physician Assistant
  • Mattapoisett, MA
National Provider Identifier
1821085945
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1579 Issued in MA
Practice address
109 Fairhaven Rd
Southcoast Primary Care Inc
Mattapoisett, MA 02739-1459
Phone
(508) 758-3781
Fax
(508) 758-4455
NPI assigned
Oct 4, 2005
Last updated
Jul 13, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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 1579 MA Primary

Addresses

Primary practice location

109 Fairhaven Rd
Southcoast Primary Care Inc
Mattapoisett, MA 02739-1459

Mailing address

370 Faunce Corner Rd
Southcoast Primary Care Inc
North Dartmouth, MA 02747-1271
Phone (508) 985-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1579MAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Hospital PastSince Jan 1, 1990 Accepting new patients
Memorial Hospital PastSince Jan 1, 1990 Accepting new patients
Memorial Hospital PastSince Jan 1, 1990 Accepting new patients
Memorial Hospital of Ri PastSince Jan 1, 1990 Accepting new patients
Southcoast Primary Care Inc Past Accepting new patients
Memorial Hospital of Rhode Island Physicians, Inc. PastSince Jan 1, 1990 Accepting new patients

Organizations & group practices 6

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1821085945",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 FAUNCE CORNER RD",
            "address_2": "SOUTHCOAST PRIMARY CARE INC",
            "city": "NORTH DARTMOUTH",
            "state": "MA",
            "postal_code": "027471271",
            "telephone_number": "508-985-2000",
            "fax_number": "508-985-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 FAIRHAVEN RD",
            "address_2": "SOUTHCOAST PRIMARY CARE INC",
            "city": "MATTAPOISETT",
            "state": "MA",
            "postal_code": "027391459",
            "telephone_number": "508-758-3781",
            "fax_number": "508-758-4455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYBALA",
        "first_name": "MICHELLE",
        "middle_name": "L",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-04",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "1579",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattapoisett, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.