ETHAN R WALSH (PA-C) – Physician Assistant, NPI 1649762071
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
5,093 PHYSICIAN ASSISTANT in MA
Provider Addresses for ETHAN R WALSH (PA-C)
PO BOX 415348
BOSTON, MA 022415348
Phone: (800) 225-8885
Type: Mailing
55 LAKE AVE N
WORCESTER, MA 016550002
Phone: (774) 443-7552
Type: Location
170 JOE SWEET RD
CHEPACHET, RI 028141924
Phone: (401) 525-8428
Type: Mailing
Rhode Island Hospital, 593, Eddy Street, Downtown, Providence, Providence County, Rhode Island, 02903, United States
PROVIDENCE, RI 029034923
Phone: (401) 444-4000
Type: Location
200 MILL RD
FAIRHAVEN, MA 027195252
Phone: (508) 973-2000
Fax: (508) 973-2001
Type: Mailing
300A FAUNCE CORNER RD
NORTH DARTMOUTH, MA 027471280
Phone: (508) 973-2213
Fax: (508) 973-1185
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-02-04
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220204000925 | I | Physician Assistant | MA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99291 | Critical care, first 30-74 minutes | 92 | 59 | $0 |
| 99292 | Critical care, each additional 30 minutes | 51 | 32 | $0 |
Insurance plans in this area (ZIP 02241)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | RI | |
| Pain Management, Anesthesiology | MA | |
| Certified Registered Nurse Anesthetist (Crna) | MA | |
| Clinical Social Worker | MA | |
| Hospitalist, Internal Medicine | MA | |
| Physician Assistant | MA | |
| H O S P I T A L I S T | MA | |
| Certified Registered Nurse Anesthetist (Crna) | RI | |
| Clinical Social Worker | MA | |
| A N E S T H E S I O L O G Y | MA |
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