Molly Dale McIntyre, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

MA054931 Issued in PA

Practice address

980 Beaver Grade Rd
Coraopolis, PA 15108-2774

Phone

(412) 262-4911

NPI assigned

Jun 22, 2011

Last updated

Oct 3, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Molly Dale Crispell Former name

Medicare fee-for-service enrollment

Enrolled in PA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Three Rivers Dermatology, LLC

  • Dermatology Physician
  • Coraopolis, PA
  • NPI 1962886424
  Medicare reassignment
• Ira JK Cohen MD PC

  • Dermatology Physician
  • Moon Township, PA
  • NPI 1316955826
  NPD (past)

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

{
    "created_epoch": "1308700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349222400000",
    "number": "1942596457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 BEAVER GRADE RD",
            "city": "CORAOPOLIS",
            "state": "PA",
            "postal_code": "151082774",
            "telephone_number": "412-262-4911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 BEAVER GRADE RD",
            "city": "CORAOPOLIS",
            "state": "PA",
            "postal_code": "151082774",
            "telephone_number": "412-262-4911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCINTYRE",
        "first_name": "MOLLY",
        "middle_name": "DALE",
        "name_prefix": "Ms.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-06-22",
        "last_updated": "2012-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "PA",
            "license": "MA054931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "CRISPELL",
            "middle_name": "DALE",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Brittany Maurizi
• Damon M. McClain, M.D.
• Briana McClintock, OTR/L
• Carolyn McElhaney, OTR/L
• Jodie McGovern, LPC
• Mark McMillen
• Med-Fast Pharmacy Inc (Med-Fast Pharmacy)
• Melissa Medvitz
• Robert Michael Medwid Jr., DMD
• Merakey Allegheny Valley School

• Medical Physician Assistant in Coraopolis, PA
• Providers in Coraopolis, PA by specialty
• Medical Physician Assistant in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.