Individual provider Active NPI

Matthew James Donovan

  • Physician Assistant
  • Everett, MA
National Provider Identifier
1972186146
Registry record updated Nov 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
103 Garland St
Everett, MA 02149-5066
Phone
(617) 389-6270
NPI assigned
May 4, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2021

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 Primary

Addresses

Primary practice location

103 Garland St
Everett, MA 02149-5066

Mailing address

47 Winford Way
Winchester, MA 01890-4030
Phone (781) 570-6067

Other identifiers 1

IdentifierTypeStateIssuer
PA8320OtherMABOARD OF REGISTRATION OF PHYSICIAN ASSISTANTS

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
I20220223002335 MA Practitioner - Physician Assistant 1850785502 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cambridge Public Health CommissionGroup PAC ID 8921910894, 654 clinicians

Practice addresses (Care Compare)

103 Garland St
Everett, MA 02149-5066
Phone (617) 389-6270

Hospital & facility affiliations

  • Cambridge Health Alliance Hospital, Cambridge, MA, CCN 220011

Merit-based Incentive Payment System (MIPS)

Final score
91.27 of 100Reported as group
Quality
77.51
Promoting interoperability
100
Improvement activities
40
Cost
76.72

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cambridge Public Health Commission CurrentSince Nov 9, 2021 Accepting new patients
Cambridge Public Health Commission Current Accepting new patients

Locations

1493 Cambridge St
Cambridge, MA 02139
Phone (617) 665-1185

103 Garland St
Everett, MA 02149
Phone (617) 381-7150

Interoperability endpoints

  • Direct secure messaging: mdonovan113189@direct.challiance.masshiway.net

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 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": "1620086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636934400000",
    "number": "1972186146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 WINFORD WAY",
            "city": "WINCHESTER",
            "state": "MA",
            "postal_code": "018904030",
            "telephone_number": "781-570-6067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 GARLAND ST",
            "city": "EVERETT",
            "state": "MA",
            "postal_code": "021495066",
            "telephone_number": "617-389-6270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DONOVAN",
        "first_name": "MATTHEW",
        "middle_name": "JAMES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-05-04",
        "last_updated": "2021-11-15",
        "certification_date": "2021-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF REGISTRATION OF PHYSICIAN ASSISTANTS",
            "identifier": "PA8320",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, MA

Sources for this page

Verify at the official NPI Registry.