Individual provider Active NPI

Dennis Matthew McKinnon, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Beverly, MA
National Provider Identifier
1851125751
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
RN272617 Issued in MA
Practice address
50 Dunham Rd Ste 32003350
Beverly, MA 01915-1882
Phone
(978) 545-9958
NPI assigned
Sep 2, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X RN272617 MA Primary

Addresses

Primary practice location

50 Dunham Rd Ste 32003350
Beverly, MA 01915-1882

Mailing address

35 Boxford Rd
Rowley, MA 01969-2424
Phone (617) 240-7480

Other practice location 1

35 Boxford Rd
Rowley, MA 01969-2424
Phone (617) 240-7480

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
I20250108000276 MA Practitioner - Nurse Practitioner 4880122613 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northeast Health Services LLCGroup PAC ID 6901866706, 470 clinicians

Practice addresses (Care Compare)

50 Dunham Ridge Rd
Suite 3200 3350
Beverly, MA 01915
Phone (978) 600-0816

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Health Services, LLC CurrentSince Jan 1, 2025 Accepting new patients

Locations

50 Dunham Rd
Ste 32003350
Beverly, MA 01915
Phone (978) 545-9958

30 Taunton Grn
Ste 5
Taunton, MA 02780
Phone (508) 545-7400

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

NPI Registry JSON

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

{
    "created_epoch": "1725235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1851125751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 BOXFORD RD",
            "city": "ROWLEY",
            "state": "MA",
            "postal_code": "019692424",
            "telephone_number": "617-240-7480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 DUNHAM RD STE 32003350",
            "city": "BEVERLY",
            "state": "MA",
            "postal_code": "019151882",
            "telephone_number": "978-545-9958"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35 Boxford Rd",
            "address_purpose": "LOCATION",
            "city": "Rowley",
            "state": "MA",
            "postal_code": "019692424",
            "country_code": "US",
            "telephone_number": "617-240-7480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCKINNON",
        "first_name": "DENNIS",
        "middle_name": "MATTHEW",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-09-02",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MA",
            "license": "RN272617",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beverly, MA

Sources for this page

Verify at the official NPI Registry.