Individual provider Active NPI

Andrea Meyer, PA

  • Medical Physician Assistant
  • Southbridge, MA
National Provider Identifier
1831446962
Registry record updated Feb 18, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA6882 Issued in MA
Practice address
100 South St
Southbridge, MA 01550-4051
Phone
(508) 765-9771
NPI assigned
Aug 8, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA6882 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 CT
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
I20121221000216 CT Practitioner - Physician Assistant 2163674144 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Day Kimball Medical Group IncGroup PAC ID 1557514411, 91 clinicians

Practice addresses (Care Compare)

132 Westminster Rd
Family Medicine Canterbury
Canterbury, CT 06331-1454
Phone (860) 546-2225

320 Pomfret St
Putnam, CT 06260-1836
Phone (860) 928-6541

Hospital & facility affiliations

  • Day Kimball Hospital Hospital, Putnam, CT, CCN 070003

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2844CTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Trinity Health of New England Provider Network Organization Inc CurrentSince Oct 22, 2012 Accepting new patients
Umass Memorial Health-Harrington Hospital Inc Past Accepting new patients

Locations

114 Woodland St
Hartford, CT 06105
Phone (860) 714-4001

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.

Hospital & facility affiliations 2

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": "1344384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550448000000",
    "number": "1831446962",
    "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": "MEYER",
        "first_name": "ANDREA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-08-08",
        "last_updated": "2019-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MA",
            "license": "PA6882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southbridge, MA

Sources for this page

Verify at the official NPI Registry.