MR. LARRY LEE MASTERSON (NPI# 1568627917) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568627917 |
| Entity Type | Individual |
| Full Name | MR. LARRY LEE MASTERSON |
| Credential | PA-C |
| Practice Address |
2150 Main Street Springfield Medical Assoc. Inc. Springfield MA 01104 |
| Practice Telephone | 4137395676 |
| Practice Fax Number | 4137335860 |
| Mailing Telephone | 4137395676 |
| Mailing Fax Number | 4137335860 |
| Enumeration Date | 2008-07-25 |
| Last Update Date | 2017-02-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA5547 | MA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363A00000X | Physician Assistant | 533 | MT | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MT | 720443 | 05 |
| Street Address |
2150 MAIN STREET SPRINGFIELD MEDICAL ASSOC. INC. |
| City | SPRINGFIELD |
| State | MA |
| Zip Code | 01104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346727567 | Genoa Healthcare, LLC | Durable Medical Equipment & Medical Supplies | 2155 Main Street, Suite 131/133, Springfield, MA 01104 | 2018-07-20 |
| 1508385618 | Demetrios Sotiropoulos | Physician Assistant | 175 Carew St Ste 250, Springfield, MA 01104 | 2017-09-11 |
| 1114382942 | Rosana Rivera-delgado | Psychologist | 4017 Liberty St, Springfield, MA 01104 | 2015-12-21 |
| 1417363516 | Springfield Family Pharmacy, Inc | Pharmacy | 175 Carew St, Suite 100, Springfield, MA 01104 | 2014-07-09 |
| 1437588837 | Ariam Ivette Pena | Counselor | 85 St. George Road, Springfield, MA 01104 | 2013-11-06 |
| 1891124293 | Ana E. Centeno | Counselor | 85 St. George Road., Springfield, MA 01104 | 2013-11-06 |
| 1275962003 | Swany Matos | Counselor | 2155 Main St., Springfield, MA 01104 | 2013-11-02 |
| 1184053910 | Claudia Eileen Quesada | Counselor | 2155 Main Street and St. George Road, The Gandara Center, Springfield, MA 01104 | 2013-11-02 |
| 1194023044 | Hungry Hill Family Practice | Clinic/Center | 776 Liberty Street, Hungry Hill Family Practice, Springfield, MA 01104 | 2011-03-02 |
| 1710115308 | Michael Allen Roche | Counselor | 332 Bernie Ave, Center for Human Development, Springfield, MA 01104 | 2009-06-23 |
| Find all providers in zip 01104 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972123289 | Jared Anthony Dias | Physician Assistant | 52 Devens St, Springfield, MA 01151-2304 | 2020-04-16 |
| 1659990976 | Maham Siddiqui | Physician Assistant | 8632 Hillside Manor Dr, Springfield, VA 22152-2238 | 2020-04-16 |
| 1558994772 | Kayla Rice | Physician Assistant | 3640 Main St Ste 103, Springfield, MA 01107-1139 | 2020-02-17 |
| 1487286563 | Michayla Marcil | Physician Assistant | 280 Chestnut St Fl 2, Springfield, MA 01199-1001 | 2020-02-06 |
| 1508416140 | Chase Michael Collings | Physician Assistant | 960 N 16th St Ste 303, Springfield, OR 97477 | 2019-09-16 |
| 1023670593 | Michael Peter Lembotesis | Physician Assistant | 629 Evans Rd, Springfield, PA 19064-3033 | 2019-07-03 |
| 1245795558 | Alexandra Marie Cutler | Physician Assistant | 1437 S Gelven Ave, Springfield, MO 65804-2124 | 2019-01-31 |
| 1598265894 | Kelsey L. Magill | Physician Assistant | 3231 S National Ave Ste 440, Springfield, MO 65807-7304 | 2018-02-14 |
| 1447759592 | Darrell Dewain Edwards | Physician Assistant | 4350 S National Ave Ste C200, Springfield, MO 65810-2782 | 2018-02-05 |
| 1164930087 | Ashley Jean Nichole Leutze | Physician Assistant | 1164 E Home Rd Ste J, Springfield, OH 45503-2726 | 2018-01-12 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 01104 |
Please comment or provide details below to improve the information on MR. LARRY LEE MASTERSON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.